- 273 Downloads
Patients with traumatic brain injury (TBI) may present several respiratory complications during the acute and subacute phases. These complications may become chronic, depending on the extent of the injury. The objective of this chapter is to describe the respiratory rehabilitation in the patient with TBI in the hospital environment. Among the physiotherapeutic interventions performed in patients on mechanical ventilation (MV) are bronchial hygiene therapy, spontaneous breathing test, inspiratory muscle training, alveolar recruitment, and early mobilization. After withdrawal from MV, some respiratory alterations justify the need for specific physiotherapeutic interventions such as pulmonary expansion therapy and bronchial hygiene maneuvers, respiratory muscle training, and mobilization. These interventions for respiratory rehabilitation may have a positive impact on the outcomes of patients with TBI admitted to the intensive care unit. However, it is essential that these interventions are indicated in a timely manner.
KeywordsRehabilitation Respiratory therapy Traumatic brain injury
- 13.Acute Respiratory Distress Syndrome N, Brower RG, Matthay MA, Morris A, Schoenfeld D, Thompson BT, Wheeler A. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000;342:1301–8.CrossRefGoogle Scholar
- 14.Brower RG, Lanken PN, MacIntyre N, Matthay MA, Morris A, Ancukiewicz M, Schoenfeld D, Thompson BT, National Heart L, Blood Institute ACTN. Higher versus lower positive end-expiratory pressures in patients with the acute respiratory distress syndrome. N Engl J Med. 2004;351:327–36.CrossRefGoogle Scholar
- 15.Meade MO, Cook DJ, Guyatt GH, Slutsky AS, Arabi YM, Cooper DJ, Davies AR, Hand LE, Zhou Q, Thabane L, Austin P, Lapinsky S, Baxter A, Russell J, Skrobik Y, Ronco JJ, Stewart TE, Lung Open Ventilation Study I. Ventilation strategy using low tidal volumes, recruitment maneuvers, and high positive end-expiratory pressure for acute lung injury and acute respiratory distress syndrome: a randomized controlled trial. JAMA. 2008;299:637–45.CrossRefGoogle Scholar
- 18.Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, Spears L, Miller M, Franczyk M, Deprizio D, Schmidt GA, Bowman A, Barr R, McCallister KE, Hall JB, Kress JP. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009;373:1874–82.CrossRefGoogle Scholar