Authors: (including presenting author): :
Lam LLF, Tse WHK, Ip WW, Pak MAM, Ip SYW, Chao CYL, Leung CYY
Affiliation: :
Physiotherapy Department, Princess Margaret Hospital
Keyword 1: :
Mobile Team for Assisted Ventilation (MAV))
Keyword 2: :
Respiratory Physiotherapy
Keyword 3: :
Invasive mechanical ventilation (IMV)
Keyword 4: :
Non-invasive ventilation (NIV)
Introduction: :
The Mobile Team for Assisted Ventilation was established in October 2020 at Princess Margaret Hospital, aiming to improve the quality of care for patients requiring invasive mechanical ventilation (IMV) and non-invasive ventilation (NIV) in acute general medical wards. The mobile team comprises doctors, nurses, and physiotherapists to provide specialist input and align treatment goals for enhancing efficiency and capacity. Ventilator patients are stratified by respiratory specialists into three categories based on their premorbid health status and expected response to treatment for determining the level of care required and team assignment. Category 1 for good potential cases needing ICU care, Category 2 for moderate potential cases needing specialized mobile respiratory team care, and Category 3 for limited potential cases managed by parent medical teams. For patients classified as Category 2, an additional session of mobile respiratory physiotherapy service would be delivered to provide both chest physiotherapy and mobilization training on weekdays for facilitating ventilator weaning and improving physical mobility.
Objectives: :
To evaluate the effects of enhanced mobile respiratory physiotherapy services for people with assisted ventilation in acute general medical wards on promoting weaning and functional recovery.
Methodology: :
This was a retrospective study design. Patients requiring ventilator support, either IMV or NIV, in the acute general medical wards of PMH and triaged by respiratory specialists as Category 2 between April 2024 and September 2025 were included in the analysis. Outcome measures on Modified Functional Ambulation Classification (MFAC) scale and handgrip strength recorded at the initiation of ventilation support and upon discontinuation were retrieved for analysis. Additionally, the number of days requiring ventilator support and the hospital length of stay were also evaluated.
Result & Outcome: :
Two hundred and sixty-eight (152 males, 116 females) Category 2 ventilator patients (NIV=180, IMV=88) with a mean age of 76.9 ±13.0 years received mobile respiratory physiotherapy services in the study period. A total of 1,829 sessions of enhanced mobile respiratory physiotherapy services were delivered. On average, each ventilator patient, either invasive or non-invasive, received 6.8 sessions of mobile respiratory physiotherapy services in addition to the usual physiotherapy service provided by the primary parent team. The average number of days required for ventilation support was 7.1±5.0 days in the NIV group and 12.1±8.5 days in the IMV group. The average hospital length of stay was 25.5±12.7 days. Upon successful weaning from the ventilation support, the proportion of patients with MFAC >3 (dependent walker or above) increased from 10.0% to 22.2% in the NIV group and 0% to 1.1% in the IMV group. Simultaneously, the right handgrip strength improved from 12.0±8.8 to 12.8±8.5kgf for NIV patients and 3.5±2.7 to 5.2±4.2kgf in IMV patients (all p< 0.05). Preliminary findings demonstrated that enhanced mobile team respiratory physiotherapy services improve weaning rates, muscle strength and functional mobility among people with fair baseline health status requiring assisted ventilation in acute general medical wards.
