A retrospective study of physiotherapy management for patients with pneumonia requiring invasive ventilation in a single-center Australian ICU.

The study came from one Level 3 ICU in Western Australia, so local practice and culture may not match other ICUs. It reviewed records of 66 adults from 208 potential cases, and many patients were excluded, so the sample may not represent all ventilated pneumonia patients. The design was retrospective, so documentation may be incomplete or missing, and the researchers could not determine why each intervention was chosen. Physiotherapy interventions were not standardized, and several respiratory and mobilization treatments were delivered together, so the contribution of any single technique cannot be separated. The study did not compare physiotherapy with no physiotherapy or different treatment doses, so it cannot show whether treatment improved ventilator-free days, length of stay, or mobility. Researchers were not blinded to the study purpose. Only seven patients had documented ARDS, so the study could not analyse that subgroup. Pneumonia diagnosis lacked standardized criteria, so comparison with other studies is limited.

The authors declared no competing interests. One author received a Health Sciences Scholarship from Curtin University to assist with data collection.

Do not read the association between more physiotherapy episodes and fewer ventilator-free days as evidence that physiotherapy worsened or improved outcomes. The study did not compare treatment with no treatment, and the authors state that the retrospective design cannot show causation.