Thesis (Ph. D.)--University of Wisconsin--Madison, 1985. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 250-260).

Thesis--Wisconsin. / Includes bibliographical references (leaves 36-40).

Thesis (MScPhys)--University of Stellenbosch, 2007. / Bibliography. Also available via the Internet.

Thesis (M.S.)--University of Wisconsin--Madison. / Typescript. Includes bibliographical references (leaves 25-27).

Thesis (M.S.)--University of Wisconsin--Madison. / Typescript. Title from title screen (viewed July 30, 2007). Includes bibliographical references (leaves 25-27). Online version of the print original.

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It is a common practice for physiotherapists working in Intensive Care Unit (ICU) to treat patients who are intubated and mechanically ventilated and assist with extubation. The role of chest physiotherapy treatment (CPT) with extubation hasn’t been scientifically proven to be effective. Purpose of the Study The purpose of this pilot study was to determine whether the omission of one CPT prior to extubation influences the outcome of patients four-hours after extubation. Methods A randomized-controlled trial (RCT) was conducted in an academic hospital with 20- cardiothoracic and general ICU beds. Patients consented to participate in the study after ethical clearance was obtained from University of Witwatersrand Committee for Research on Human Subjects. Twenty-two patients were randomly assigned to a control group to receive CPT and suctioning prior to extubation (n=12) or to an experimental group to receive suctioning only prior to extubation (n=10). All patients were then re-assessed four-hours after extubation to assess the difference in outcome measures in arterial blood gases (ABG), breathing pattern, peak expiratory flow rate (PEFR), respiratory rate (RR), cough effectiveness and re-intubation rate. Groups were compared with respect to the categorical parameters using the Fischer’s exact test. A two-sample t-test with unequal variances and a non-parametric Mann-Whitney test were used to compare the ABG and RR results between the groups. Results and Discussion The ABG, breathing pattern, RR, and cough effectiveness were not statistically significant between the groups. PEFR could not be measured due to the inability to follow instruction by the majority of patients. None of the patients required re-intubation within 24-hours. Eight patients in each group received CPT after four-hours due to clinical findings of an ineffective cough, added sounds and abnormal breathing patterns. Conclusion: Patients in the control group had a significant shorter period of mechanical ventilation (MV) than those allocated in the experimental group. However eight patients in both groups required CPT treatment when assessed four hours after extubation.

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