Chest physiotherapy in blunt chest trauma in intensive care unit : why, when and how ?

Abstract

Introduction: Chest trauma’s initial management in the Intensive Care Unit (ICU) aims at stabilizing the hemodynamic and respiratory status of the patient, and at obtaining satisfactory analgesia. Physiotherapy, important part of care, aims at preventing and/or treating some pulmonary complications. From a case report, we will discuss timing as well as means of physiotherapy management.

Observation: Mr D, 21 years old, has been admitted in the ICU following a severe blunt chest trauma (Injury Severity Score > 15/75) leading to a non compressive hemopneumothorax. Multi-day physiotherapy sessions were based on manual techniques associated to incentive spirometry.

Conclusion: During his stay, different manual techniques were used to treat and prevent some pulmonary complications. If physiotherapy seems to be proven, modalities in term of implementation time and means used remain blurry and need further research.