Cardiopulmonary effects of physiotherapy program in intensive care unit after liver transplantation

Aim: To determine the effects of physiotherapy in intensive care unit on cardiopulmonary system after liver transplantation.Method: 13 liver transplant recipients (7 female, 6 male), mean age 44.38±10.60 participated in the study. Physiotherapy program including pulmonary physiotherapy, active range of motion exercises, sitting in bed (1st task), sitting on the edge of bed (2nd task), standing (3rd task), sitting out of bed (4th task) and walking (5th task) were applied to the patients in Dokuz Eylul University Anesthesiology Intensive Care Unit. Heart rate (HR), systolic/diastolic/mean arterial blood pressures (SBP/DBP/MABP), peripheral oxygen saturation (SpO2) and respiratory rate (RR) were recorded from patient monitor before treatment, after each task, just after treatment and five minutes of the recovery period. Severity of pain was assessed at each task with Visual Analog Scale.Results: After 1st task HR, SBP, DBP, MABP, SpO2 and severity of pain increased significantly compared to pre-treatment measures (p<0.05). After 2nd task HR, SBP, MABP and severity of pain increased significantly compared to pre-treatment measures whereas SBP and SpO2 decreased significantly compared to 1st task (p<0.05). HR and severity of pain increased significantly after 3rd task compared to pre-treatment measures whereas only HR increased significantly compared to 2nd task measurements (p<0.05). There were no statistically significant difference between 4th task and pre-treatment values, but HR and severity of pain decreased significantly after 4th task in comparison to 3rd task (p<0.05). HR, DBP and severity of pain increased significantly compared to pre-treatment measures; HR, RR and severity of pain increased significantly compared to 4th task after 5th task.Conclusion: Intensive care physiotherapy after liver transplantation leads to significant cardiopulmonary changes due to its cardiopulmonary load. Returning to initial values after 5minutes shows the tolerance of this cardiopulmonary stress and fast recovery.Key words: liver transplantation, intensive care unit, physiotherapy