Effects of Ankle Pumping Exercises on Limb Edema in Critically ill Patients with Acute Respiratory Distress Syndrome

Humna Gul; Arooj Fatima; Ashfaq Ahmad; Syed Amir Gilani

doi:10.54393/tt.v2i2.26

Authors

Humna Gul University Institute of Physical Therapy, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
Arooj Fatima University Institute of Physical Therapy, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
Ashfaq Ahmad University Institute of Physical Therapy, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
Syed Amir Gilani University Institute of Physical Therapy, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan

DOI:

https://doi.org/10.54393/tt.v2i2.26

Keywords:

Acute respiratory distress syndrome; mobility therapy; physiotherapy treatment

Abstract

Acute Respiratory Distress Syndrome (ARDS) is an acute respiratory disease in which the respiratory activity of the lungs is compromised due to secretion of fluid in the alveoli of lungs and thus depriving the blood stream with optimal oxygen supply. Objective: To determine the effects of ankle pumping exercises on limb edema in critically ill patients with acute respiratory distress syndrome Methods: A sample of 67 patients was selected by using non-probability convenient sampling from different hospital settings. Ventilated patients or those having endotracheal tube, age between 40-65 years, and either gender were included in the study. Results: The effect of Range of Motion (ROM) on ARDS patients was as high as 91 %. There were 61(91.0) responders who experienced edema reduced by ankle pumping 54(80.6) found prone position and 13(19.4) found supine position effective 53(79.1) having resonant sound and 14(20.9) with hyper stony dullness 24(35.8) person having added sound and 43(64.2) crepitus sound in this study. In this study, 20 out of 67 patients who were admitted to the intensive care unit (ICU) developed acute onset of severe dyspnea, hypoxemia, and cyanosis and decreased respiratory system compliance, despite supplemental oxygen and mechanical ventilation. Edema had been reduced by ankle pumping in 61 subjects. Conclusions: Patients with ARDS report improvement in symptoms with physiotherapy treatment, ROM exercises had remarkable effects on such patients.

References

Fan E, Brodie D, Slutsky AS. Acute respiratory distress syndrome: advances in diagnosis and treatment. Jama. 2018;319(7):698-710. doi: 10.1001/jama.2017.21907

Vitor J. Cuidados de enfermagem especializados à pessoa submetida à oxigenação por membrana extracorpórea: Do Pré-Hospitalar à Unidade de Cuidados Intensivos 2018. https://comum.rcaap.pt/handle/10400.26/24314

Gattinoni L, Tonetti T, Cressoni M, Cadringher P, Herrmann P, Moerer O, et al. Ventilator-related causes of lung injury: the mechanical power. Intens. Care Med. 2016;42(10):1567-75. doi: 10.1007/s00134-016-4505-2

Berney S, Denehy L. A comparison of the effects of manual and ventilator hyperinflation on static lung compliance and sputum production in intubated and ventilated intensive care patients. Physioth. Res. Inter. 2002;7(2):100-8. doi: 10.1002/pri.246

Herridge MS, Cheung AM, Tansey CM, Matte-Martyn A, Diaz-Granados N, Al-Saidi F, et al. One-year outcomes in survivors of the acute respiratory distress syndrome. N. Eng. J. Med. 2003;348(8):683-93. doi: 10.1056/NEJMoa022450.

Combes A, Costa M-A, Trouillet J-L, Baudot J, Mokhtari M, Gibert C, et al. Morbidity, mortality, and quality-of-life outcomes of patients requiring≥ 14 days of mechanical ventilation. Crit. Care Med. 2003;31(5):1373-81. doi: 10.1097/01.CCM.0000065188.87029.C3

Fletcher SN, Kennedy DD, Ghosh IR, Misra VP, Kiff K, Coakley JH, et al. Persistent neuromuscular and neurophysiologic abnormalities in long-term survivors of prolonged critical illness. Crit. Care Med. 2003;31(4):1012-6. doi: 10.1097/01.CCM.0000053651.38421.D9

Carson SS, Bach PB. The epidemiology and costs of chronic critical illness. Crit. care clin. 2002;18(3):461-76. doi: 10.1016/s0749-0704(02)00015-5

Jones AY, Hutchinson RC, Oh TE. Chest physiotherapy practice in intensive care units in Australia, the UK and Hong Kong. Physio. Theo. Prac. 1992;8(1):39-47. https://doi.org/10.3109/09593989209108078

Norrenberg M, Vincent J-L. A profile of European intensive care unit physiotherapists. Intens. Care Med. 2000;26(7):988-94. doi: 10.1007/s001340051292

Roussos C. Function and fatigue of respiratory muscles. Chest. 1985;88(2):124S-32S. doi: 10.1378/chest.88.2_supplement.124s

Gattinoni L, Marini JJ, Collino F, Maiolo G, Rapetti F, Tonetti T, et al. The future of mechanical ventilation: lessons from the present and the past. Crit. Care. 2017;21(1):183. doi: 10.1186/s13054-017- 1750-x

Morris PE, Goad A, Thompson C, Taylor K, Harry B, Passmore L, et al. Early intensive care unit mobility therapy in the treatment of acute respiratory failure. Crit. Care Med. 2008;36(8):2238-43. doi: 10.1097/CCM.0b013e318180b90e

Herridge MS, Moss M, Hough CL, Hopkins RO, Rice TW, Bienvenu OJ, et al. Recovery and outcomes after the acute respiratory distress syndrome (ARDS) in patients and their family caregivers. Inten. Care Med. 2016;42(5):725-38. doi: 10.1007/s00134-016-4321-8

Keenan SP, Gregor J, Sibbald WJ, Cook D, Gafni A. Noninvasive positive pressure ventilation in the setting of severe, acute exacerbations of chronic obstructive pulmonary disease: more effective and less expensive. Crit. Care Med. 2000;28(6):2094-102. doi: 10.1097/00003246-200006000-00072

Hilbert G, Gruson D, Vargas F, Valentino R, Gbikpi-Benissan G, Dupon M, et al. Noninvasive ventilation in immunosuppressed patients with pulmonary infiltrates, fever, and acute respiratory failure. New England Journal of Medicine. 2001;344(7):481-7. doi: 10.1056/NEJM200102153440703

Clini E, Ambrosino N. Early physiotherapy in the respiratory intensive care unit. Respiratory medicine. 2005 Sep 1;99(9):1096-104. https://doi.org/10.1016/j.rmed.2005.02.024.

Chatte G, Sab JM, Dubois JM, Sirodot M, Gaussorgues P, Robert D. Prone position in mechanically ventilated patients with severe acute respiratory failure. American journal of respiratory and critical care medicine. 1997 Feb;155(2):473-8.https://pubmed.ncbi.nlm.nih.gov/9032181.

Esteban A, Alia I, Ibañez J, Benito S, Tobin MJ, Group SL. Modes of mechanical ventilation and weaning: a national survey of Spanish hospitals. Chest. 1994 Oct 1;106(4):1188-93. https://doi.org/10.1378/chest.106.4.1188.

Morris PE, Goad A, Thompson C, Taylor K, Harry B, Passmore L, Ross A, Anderson L, Baker S, Sanchez M, Penley L. Early intensive care unit mobility therapy in the treatment of acute respiratory failure. Critical care medicine. 2008 Aug 1;36(8):2238-43. doi: 10.1097/CCM.0b013e318180b90e.