The Implementation of Physiotherapist-Led Lung Ultrasound on Physiotherapy and Medical Clinical Decision-Making in Intensive Care Patients: A Retrospective Review

Abstract

Purpose: The clinical use of lung ultrasound (LUS) is gaining acceptance and rapidly growing. Lung ultrasound is being integrated into clinical care by trained respiratory physiotherapists and has been reported to influence physiotherapists' clinical decision-making in the respiratory management of patients. The purpose of this study was to evaluate the implementation of physiotherapist-led LUS on physiotherapy and medical clinical decision-making in a single intensive care unit (ICU). Methods: This was a retrospective review using descriptive analyses of a senior ICU physiotherapist's LUS scans. Results: Of the 40 LUS scans completed, 26 (65%) were clinically indicated, and 31 (77.5%) were identified as positive scans. After LUS, respiratory physiotherapy management changed in 11 (27.5%) cases, continued unaltered in 12 (30%) cases, deemed not indicated in 4 (10%) cases, and not reported in 10 (25%) cases. Medical decision-making changed in 8 (20%) cases, continued unchanged in 14 (35%) cases, and not reported in 18 (45%) cases. Conclusions: This small retrospective review of a single physiotherapist's LUS scans suggests that LUS may have an influence on physiotherapy and medical clinical management in ICU. Research to prospectively evaluate the impact of physiotherapy-led LUS on clinical decision-making and key patient outcomes is strongly recommended.