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CHEST X-RAYS OF SPECIFIC DISEASES, THEIR INTERPRETATION AND PHYSIOTHERAPY TREATMENT (cont.)

In the name of ALLAH The Most Beneficent and The Most In the name of ALLAH The Most Beneficent and The Most Merciful.Merciful.

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CHEST X-RAYS OF CHEST X-RAYS OF SPECIFIC DISEASES, SPECIFIC DISEASES,

THEIR INTERPRETATION THEIR INTERPRETATION AND PHYSIOTHERAPY AND PHYSIOTHERAPY

TREATMENTTREATMENT

Presented By:

SAAD SALEEM

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CHEST X-RAYS OF SPECIFIC DISEASES, THEIR INTERPRETATION AND PHYSIOTHERAPY TREATMENT (cont.)

Adult Respiratory Distress Syndrome (ARDS)

Adult Respiratory Distress Syndrome (ARDS) is characterized by increased pulmonary vascular permeability, decreased lung compliance, progressive hypoxemia, and pulmonary infiltrates on chest radiographs.

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CHEST X-RAYS OF SPECIFIC DISEASES, THEIR INTERPRETATION AND PHYSIOTHERAPY TREATMENT (cont.)

Adult Respiratory Distress Syndrome

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CHEST X-RAYS OF SPECIFIC DISEASES, THEIR INTERPRETATION AND PHYSIOTHERAPY TREATMENT (cont.)Adult Respiratory Distress Syndrome (ARDS) (cont.)

Physiotherapy key points• No PT treatment unless lung collapse/excessive bronchial

secretions not being cleared by suctioning only.

• Severe hypoxia, fewer secretions; manual hyperinflation is contraindicated .

• Excess bronchial secretions or lung collapse, use manual hyperinflation. Do not give high peak airway pressure, instead give slow controlled hyperinflation. If high PEEP levels are present maintain it during hyperinflation and closed-circuit catheter should be used.

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CHEST X-RAYS OF SPECIFIC DISEASES, THEIR INTERPRETATION AND PHYSIOTHERAPY TREATMENT (cont.)

Pulmonary EdemaIt is the accumulation of fluid

in the extravascular spaces and tissues of the lung. Fluid is present in two major compartments:

• Interstitial compartment• Air spaces in the lung.

It can be:

1) Cardiogenic.

2) Non-cardiogenic. (absolute hypervolaemia)

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CHEST X-RAYS OF SPECIFIC DISEASES, THEIR INTERPRETATION AND PHYSIOTHERAPY TREATMENT (cont.)

Pulmonary Edema

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CHEST X-RAYS OF SPECIFIC DISEASES, THEIR INTERPRETATION AND PHYSIOTHERAPY TREATMENT (cont.)

Pulmonary Edema (cont.)

Physiotherapy key points• No PT treatment unless tenacious and thick secretions are

present which are not being cleared by only suctioning or ACBTs.

• If thick and tenacious secretions are present then use the same method of CPT as mentioned in ARDS.

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CHEST X-RAYS OF SPECIFIC DISEASES, THEIR INTERPRETATION AND PHYSIOTHERAPY TREATMENT (cont.)

PneumoniaPneumonia is an inflammatory

illness of the lung. Frequently, it is described as lung parenchyma/alveolar inflammation and abnormal alveolar filling with fluid. Pneumonia can result from a variety of causes, including infection with bacteria, viruses, fungi or parasites and chemical or physical injury to the lungs. Its cause may also be idiopathic.

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CHEST X-RAYS OF SPECIFIC DISEASES, THEIR INTERPRETATION AND PHYSIOTHERAPY TREATMENT (cont.)

Pneumonia

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CHEST X-RAYS OF SPECIFIC DISEASES, THEIR INTERPRETATION AND PHYSIOTHERAPY TREATMENT (cont.)

Pneumonia (cont.)

Physiotherapy key points• If the cause of pneumonia is bacterial or any other organism,

no PT treatment, unless there is a problem of thick, tenacious secretions, then PT treatment can be given as explained below.

• If cause is inhalation or burn injury, mostly the secretions after lung injuries are thick and tenacious. Humidification and nebulization is needed. Intermittent Positive Pressure Breathing or Periodic Continuous Positive Airway Pressure+ACBTs. In ventilated patients 2-3 ml of normal saline instillation with manual hyperinflation technique can be used. Chest percussions with thoracic compressions and vibrations should be given with BAD LUNG UP. NO CHEST COMPRESSIONS,VIBRATIONS OR PERCUSSIONS SHOULD BE GIVEN IF BURNS ARE PRESENT OVER CHEST WALL.

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CHEST X-RAYS OF SPECIFIC DISEASES, THEIR INTERPRETATION AND PHYSIOTHERAPY TREATMENT (cont.)

Pleural Effusion

Pleural effusion occurs when too much fluid collects in the pleural space (the space between the two layers of the pleura). It is commonly known as "water on the lungs." It is characterized by shortness of breath, chest pain, gastric discomfort (dyspepsia), and cough.

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CHEST X-RAYS OF SPECIFIC DISEASES, THEIR INTERPRETATION AND PHYSIOTHERAPY TREATMENT (cont.)

Pleural Effusion

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CHEST X-RAYS OF SPECIFIC DISEASES, THEIR INTERPRETATION AND PHYSIOTHERAPY TREATMENT (cont.)

Pleural Effusion (cont.)

Physiotherapy key points• Indicated in patients with intercostal tube.

• Ambulation should be encouraged.

• After chest trauma, vigorous exercises should be done, to improve drainage, after chest tube insertion. Mobility exercises like brisk walking up and down stairs, running, cycle pedals, steps, marching, and static bicycle. Huffing and coughing also increases drainage.

• Breathing exercises (active or passive) in patients with

underlying lung pathologies.

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CHEST X-RAYS OF SPECIFIC DISEASES, THEIR INTERPRETATION AND PHYSIOTHERAPY TREATMENT (cont.)

Atelectasis

Atelectasis is defined as a state in which the lung, in whole or in part, is collapsed or without air. It is a condition where the alveoli are deflated, as distinct from Pulmonary Consolidation.

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CHEST X-RAYS OF SPECIFIC DISEASES, THEIR INTERPRETATION AND PHYSIOTHERAPY TREATMENT (cont.)

Atelectasis

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CHEST X-RAYS OF SPECIFIC DISEASES, THEIR INTERPRETATION AND PHYSIOTHERAPY TREATMENT (cont.)

Atelectasis (cont.)

Physiotherapy key points• Frequent turning.

• Early mobilization.

• Strategies to expand the lungs:

– Deep breathing.

– Incentive Spirometry (IS).

• For intubated patients:

– Manual Hyperinflation Technique.

– Chest percussions, compressions, and vibrations.

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CHEST X-RAYS OF SPECIFIC DISEASES, THEIR INTERPRETATION AND PHYSIOTHERAPY TREATMENT (cont.)

Thank You For Your ListeningThank You For Your Listening