Abstract
Chronic obstructive pulmonary disease (COPD) is a progressive lung condition that
affects a person's ability to exercise and undertake normal physical function due
to breathlessness, poor physical fitness, and muscle fatigue. Patients with COPD often
experience exacerbations due to pulmonary infections, which result in worsening of
their symptoms, more loss of function, and often require hospital treatment or in
severe cases admission to intensive care units. Recovery from such exacerbations is
often slow, and some patients never fully return to their previous level of activity.
This can lead to permanent disability and premature death.
Physical therapists play a key role in the respiratory management and rehabilitation
of patients admitted to intensive care following acute exacerbation of COPD. This
article discusses the key considerations for respiratory management of patients requiring
invasive mechanical ventilation, providing an evidence-based summary of commonly used
interventions. It will also explore the evidence to support the introduction of early
and structured programs of rehabilitation to support recovery in both the short and
the long term, as well as active mobilization, which includes strategies to minimize
or prevent physical loss through early retraining of both peripheral and respiratory
muscles.
Keywords
COPD - intensive care unit - mechanical ventilation - respiratory physical therapy
- muscle training - early mobilization
