• Rafael S dos Santos, Márcio V F Donadio, Gabriela V da Silva, Clarissa N Blattner, Denizar A S Melo, Fernanda B Nunes, Fernando S Dias, Eamim D Squizani, Leonardo Pedrazza, Isabella Gadegast, and Jarbas R de Oliveira.
• Faculdade de Fisioterapia Hospital São Lucas, Porto Alegre, Rio Grande do Sul, Brazil.
• Respir Care. 2014 Sep 1; 59 (9): 1398-403.

BackgroundSeptic shock presents as a continuum of infectious events, generating tissue hypoxia and hypovolemia, and increased oxidative stress. Chest physiotherapy helps reduce secretion, improving dynamic and static compliance, as well as improving secretion clearance and preventing pulmonary complications. The purpose of this study was to evaluate the immediate effect of chest physiotherapy on hemodynamic, metabolic, inflammatory, and oxidative stress parameters in subjects in septic shock.MethodsWe conducted a quasi-experimental study in 30 subjects in septic shock, who underwent chest physiotherapy, without associated heart diseases and with vasopressors < 0.5 μg/kg/min. Venous and arterial blood gases, clinical and hemodynamic data, inflammatory data, lactate, and oxidative stress were evaluated before and 15 min after physiotherapy.ResultsThirty subjects with a mean age of 61.8 ± 15.9 y and Sequential Organ Failure Assessment of 8 (range 6-10) were included. Chest physiotherapy caused a normalization of pH (P = .046) and P(aCO2) (P = .008); reduction of lactate (P = .001); and an increase in P(aO2) (P = .03), arterial oxygen saturation (P = .02), and P(aO2)/F(IO2) (P = .034), 15 min after it was applied.ConclusionsThe results indicate that chest physiotherapy has immediate effects, improving oxygenation and reducing lactate and oxidative damage in subjects in septic shock. However, it does not cause alterations in the inflammatory and hemodynamic parameters.Copyright © 2014 by Daedalus Enterprises.

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