title: Immediate effects of chest physiotherapy on hemodynamic, metabolic, and oxidative stress parameters in subjects with septic shock.
abstract: BACKGROUND
  Septic 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.
  
  
  METHODS
  We 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.
  
  
  RESULTS
  Thirty 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.
  
  
  CONCLUSIONS
  The 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.
authors.affiliation: Faculdade de Fisioterapia Hospital São Lucas, Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Rafael S
authors.initials: RS
authors.lastname: dos Santos
authors.affiliation: Faculdade de Enfermagem, Nutrição e Fisioterapia.
authors.forename: Márcio V F
authors.initials: MV
authors.lastname: Donadio
authors.affiliation: Faculdade de Farmácia.
authors.forename: Gabriela V
authors.initials: GV
authors.lastname: da Silva
authors.affiliation: Faculdade de Enfermagem, Nutrição e Fisioterapia Hospital São Lucas, Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Clarissa N
authors.initials: CN
authors.lastname: Blattner
authors.affiliation: Faculdade de Enfermagem, Nutrição e Fisioterapia dmelo@pucrs.br.
authors.forename: Denizar A S
authors.initials: DA
authors.lastname: Melo
authors.affiliation: Faculdade de Biociências.
authors.forename: Fernanda B
authors.initials: FB
authors.lastname: Nunes
authors.affiliation: Faculdade de Medicina, Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Fernando S
authors.initials: FS
authors.lastname: Dias
authors.affiliation: Faculdade de Farmácia.
authors.forename: Eamim D
authors.initials: ED
authors.lastname: Squizani
authors.affiliation: Faculdade de Farmácia.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Pedrazza
authors.affiliation: Faculdade de Biociências.
authors.forename: Isabella
authors.initials: I
authors.lastname: Gadegast
authors.affiliation: Faculdade de Biociências.
authors.forename: Jarbas R
authors.initials: JR
authors.lastname: de Oliveira
mesh_terms: D000368:Aged; D001794:Blood Pressure; D002245:Carbon Dioxide / Q000097:blood; D005260:Female; D006339:Heart Rate; D006801:Humans; D006863:Hydrogen-Ion Concentration; D019344:Lactic Acid / Q000097:blood; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D026741:Physical Therapy Modalities; D056152:Respiratory Rate; D012772:Shock, Septic / Q000503:physiopathology* / Q000628:therapy*; D013396:Suction; D017392:Thiobarbituric Acid Reactive Substances / Q000378:metabolism; D013909:Thorax; D013997:Time Factors; D016212:Transforming Growth Factor beta / Q000097:blood; D014732:Vibration / Q000627:therapeutic use
chemical_list: D017392:Thiobarbituric Acid Reactive Substances; D016212:Transforming Growth Factor beta; D002245:Carbon Dioxide; D009569:Nitric Oxide; D019344:Lactic Acid; D010100:Oxygen
keywords: chest physiotherapy; intensive care; lactate; oxidative stress; oxygen; septic; shock