Settings and monitoring of mechanical ventilation during physical therapy in adult critically ill patients: protocol for a scoping review

Physical Therapy in Neurorehabilitation with an Emphasis on Sports: A Bibliometric Analysis and Narrative Review

The increasing interest in physical therapy in sports neurorehabilitation stems from the high incidence of neurological injuries among athletes and the crucial role of rehabilitation in facilitating their safe return to sports. This study aims to provide a comprehensive analysis of research trends in physical therapy and neurorehabilitation in athletes. This study presents a bibliometric analysis of 103 documents from the Scopus database, followed by a narrative review of the identified thematic areas. Together, these approaches offer a comprehensive overview of the international literature on the application of physical therapy in sports neurorehabilitation, highlighting key trends and contributors. The software VOSviewer and Power BI (2.136.1202.0) were used for the bibliometric analysis and the visualization of the results. Techniques such as performance analysis (documents per year, top sources and countries in documents, and top authors in citations) and science mapping (co-authorship, bibliographic coupling, co-citation, and co-occurrence) were conducted. The results revealed the journals and the authors with the greatest impact in the field and collaborations between various countries. From the co-occurrence analysis of the keywords, three key thematic clusters were identified, Clinical Approaches and Outcomes in Neurorehabilitation, Athlete-Centered Neurorehabilitation Techniques, and Specialized Interventions in Sports Medicine and Neurorehabilitation, which were used to conduct the narrative review. These findings provide a solid foundation for future research and clinical practice aimed at enhancing recovery times and overall performance in athletes with neurological injuries.

Respiratory Support Adjustments and Monitoring of Mechanically Ventilated Patients Performing Early Mobilization: A Scoping Review

This scoping review is aimed to summarize current knowledge on respiratory support adjustments and monitoring of metabolic and respiratory variables in mechanically ventilated adult patients performing early mobilization.

DATA SOURCES

Eight electronic databases were searched from inception to February 2021, using a predefined search strategy.

STUDY SELECTION

Two blinded reviewers performed document selection by title, abstract, and full text according to the following criteria: mechanically ventilated adult patients performing any mobilization intervention, respiratory support adjustments, and/or monitoring of metabolic/respiratory real-time variables.

DATA EXTRACTION

Four physiotherapists extracted relevant information using a prespecified template.

DATA SYNTHESIS

From 1,208 references screened, 35 documents were selected for analysis, where 20 (57%) were published between 2016 and 2020. Respiratory support settings (ventilatory modes or respiratory variables) were reported in 21 documents (60%). Reported modes were assisted (n = 11) and assist-control (n = 9). Adjustment of variables and modes were identified in only seven documents (20%). The most frequent respiratory variable was the Fio2, and only four studies modified the level of ventilatory support. Mechanical ventilator brand/model used was not specified in 26 documents (74%). Monitoring of respiratory, metabolic, and both variables were reported in 22 documents (63%), four documents (11%) and 10 documents (29%), respectively. These variables were reported to assess the physiologic response (n = 21) or safety (n = 13). Monitored variables were mostly respiratory rate (n = 26), pulse oximetry (n = 22), and oxygen consumption (n = 9). Remarkably, no study assessed the work of breathing or effort during mobilization.

CONCLUSIONS

Little information on respiratory support adjustments during mobilization of mechanically ventilated patients was identified. Monitoring of metabolic and respiratory variables is also scant. More studies on the effects of adjustments of the level/mode of ventilatory support on exercise performance and respiratory muscle activity monitoring for safe and efficient implementation of early mobilization in mechanically ventilated patients are needed.

Equations for calculating ideal body weight in patients on mechanical ventilation in adult intensive care units in Latin America: exploratory review

Introduction: Ideal body weight calculation is used in critical medicine for drug dosing and setting ventilation parameters. However, the suggested and used equations were designed on the basis of anthropometric variables that do not represent the Latin American population. Objective: To map and present the current evidence on the equations used to calculate ideal weight in patients on mechanical ventilation in intensive care units in Latin America. Material and Methods: Exploratory review using the Joanna Briggs Institute method conceived by Arskey / O’Malley. A search was performed in the BVS, LILLACS, REDALYC, Ovid, Google Scholar and Scielo databases using keywords and MeSH terms in Spanish, English, and Portuguese, with no time limitation. The results are presented in descriptive tables. Results: Overall, 1126 studies were identified and 1120 were excluded; 6 studies were reviewed and 3 additional studies were identified through a manual search. The studies were published in Chile, Brazil, Mexico, Ecuador, and Peru. In 89%, the ARDS Network equation was used to calculate tidal volume. Acute respiratory distress syndrome was the most reported pathology (33%). Conclusions: Adult intensive care units in Latin America use the equation suggested by the ARDS Network, which was designed in a population with different anthropometric characteristics.