Physiotherapy in the intensive care unit

The purpose of the present review is to describe the physiotherapy treatment in the Intensive Care Unit (ICU). Physiotherapy is a part of the multidisciplinary management in ICU. Physiotherapists perform an assessment which includes the respiratory, cardiovascular, neurological, and musculoskeletal systems to formulate treatment plans. Primary focus of treatment has been the respiratory and musculoskeletal management of both intubated and spontaneously breathing patients. Particularly, the goals of respiratory and musculoskeletal physiotherapy management are: (a) to promote secretion clearance, (b) to maintain or recruit lung volume, (c) to optimize oxygenation, (d) to prevent respiratory complications, (e) to maintain joint and muscle function, (f) to promote early mobilization, (g) to prevent and reduce muscle atrophy and weakness, and (h) to reduce patient deconditioning and related problems (i.e., impaired functional exercise capacity, physical inactivity). A variety of modalities for respiratory and early mobility is evidence-based and must be implemented depending on the pathology of the critically ill patient and co-morbid conditions.