Physiotherapy for people with severe lung failure

Patients experiencing severe lung failure are put on specialist life support called extracorporeal membrane oxygenation (ECMO). They are very ill and have a complex range of lung problems.

There hasn’t been much research into this patient group yet. The NHS guidance for their treatment doesn’t include standards for physiotherapy.

Project aims

Our aim for this project was to focus on airway clearance techniques. We wanted to see how helpful they might be for people with severe lung failure on ECMO.

What we did

To refine the direction of this project, we developed and published a scoping review protocol. Tom Lunn, the lead researcher, will now conduct the review. He will look at airway clearance techniques in adults receiving ECMO.

ECMO is a form of life support that temporarily takes over the work of the heart and/or lungs by circulating blood through a machine. This machine removes carbon dioxide and adds oxygen. It is used for people who are severely unwell.

Tom will look at available evidence on airway clearance techniques in this patient group. He will look at:

• Which techniques are used
• Why and how they are used
• Outcomes
• Safety considerations

Alongside preparing the scoping review protocol, Tom also worked with national and international experts in critical care, respiratory physiotherapy and ECMO. He explored the challenges associated with airway clearance during ECMO.

As a result of this he developed a commentary examining how severe respiratory failure and the need for ECMO may affect the way patients airways are cleared.

This work helped identify areas where current practice is based on physiology and expert opinion rather than strong evidence, highlighting priorities for future research.