{"id":8090,"date":"2023-12-04T16:22:49","date_gmt":"2023-12-04T16:22:49","guid":{"rendered":"https:\/\/langs.physio-pedia.com\/respiratory-physiotherapy-for-icu-patients-it\/"},"modified":"2026-04-10T11:42:53","modified_gmt":"2026-04-10T11:42:53","slug":"respiratory-physiotherapy-for-icu-patients-it","status":"publish","type":"page","link":"https:\/\/langs.physio-pedia.com\/it\/respiratory-physiotherapy-for-icu-patients-it\/","title":{"rendered":"Fisioterapia respiratoria per i pazienti nell&#8217;unit\u00e0 di terapia intensiva"},"content":{"rendered":"<div class=\"mw-parser-output\">\n<div class=\"editorbox\">\n<p><b>Redazione originale <\/b> &#8211; <a title=\"User:Merinda Rodseth\" href=\"\/User:Merinda_Rodseth\">Merinda Rodseth<\/a><\/p>\n<p><b>Collaboratori principali<\/b> &#8211; <a class=\"mw-userlink\" title=\"User:Merinda Rodseth\" href=\"\/User:Merinda_Rodseth\"><bdi>Merinda Rodseth<\/bdi><\/a>, <a class=\"mw-userlink\" title=\"User:Kim Jackson\" href=\"\/User:Kim_Jackson\"><bdi>Kim Jackson<\/bdi><\/a>, <a class=\"mw-userlink\" title=\"User:Stacy Schiurring\" href=\"\/User:Stacy_Schiurring\"><bdi>Stacy Schiurring<\/bdi><\/a>, <a class=\"mw-userlink\" title=\"User:Jess Bell\" href=\"\/User:Jess_Bell\"><bdi>Jess Bell<\/bdi><\/a>, <a class=\"mw-userlink\" title=\"User:Ewa Jaraczewska\" href=\"\/User:Ewa_Jaraczewska\"><bdi>Ewa Jaraczewska<\/bdi><\/a>, <a class=\"mw-userlink\" title=\"User:Tarina van der Stockt\" href=\"\/User:Tarina_van_der_Stockt\"><bdi>Tarina van der Stockt<\/bdi><\/a>, <a class=\"mw-userlink\" title=\"User:Uchechukwu Chukwuemeka\" href=\"\/User:Uchechukwu_Chukwuemeka\"><bdi>Uchechukwu Chukwuemeka<\/bdi><\/a> e <a class=\"mw-userlink\" title=\"User:Lucinda hampton\" href=\"\/User:Lucinda_hampton\"><bdi>Lucinda Hampton<\/bdi><\/a><\/p>\n<\/div>\n<div id=\"toc\" class=\"toc\" role=\"navigation\" aria-labelledby=\"mw-toc-heading\"><input id=\"toctogglecheckbox\" class=\"toctogglecheckbox\" style=\"display: none;\" role=\"button\" type=\"checkbox\"><\/p>\n<div class=\"toctitle\" dir=\"ltr\" lang=\"en\">\n<h2 id=\"mw-toc-heading\">Contenuti<\/h2>\n<\/div>\n<ul>\n<li class=\"toclevel-1 tocsection-1\"><a href=\"#The_Respiratory_System\"><span class=\"tocnumber\">1<\/span> <span class=\"toctext\">L&#8217;apparato respiratorio<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-2\"><a href=\"#Aims_of_Physiotherapy\"><span class=\"tocnumber\">2<\/span> <span class=\"toctext\">Obiettivi della fisioterapia<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-3\"><a href=\"#Physiotherapy_Modalities_for_Respiratory_Care\"><span class=\"tocnumber\">3<\/span> <span class=\"toctext\">Modalit\u00e0 fisioterapiche per l&#8217;assistenza respiratoria<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-4\"><a href=\"#Modalities_for_Airway_Secretion_Clearance\"><span class=\"tocnumber\">3.1<\/span> <span class=\"toctext\">Modalit\u00e0 per la clearance delle secrezioni delle vie aeree<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-5\"><a href=\"#Modalities_for_Enhancing_Lung_Volume\/Improvement_of_Atelectasis\"><span class=\"tocnumber\">3.2<\/span> <span class=\"toctext\">Modalit\u00e0 per aumentare il volume polmonare\/migliorare l&#8217;atelettasia<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-6\"><a href=\"#Modalities_for_Improvement_of_Oxygenation_(Gas_exchange)\"><span class=\"tocnumber\">3.3<\/span> <span class=\"toctext\">Modalit\u00e0 per migliorare l&#8217;ossigenazione (scambio di gas)<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-7\"><a href=\"#Modalities_to_Maintain_or_Improve_Inspiratory_Muscle_Strength\"><span class=\"tocnumber\">3.4<\/span> <span class=\"toctext\">Modalit\u00e0 per mantenere o migliorare la forza dei muscoli inspiratori<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-8\"><a href=\"#Conclusion\"><span class=\"tocnumber\">4<\/span> <span class=\"toctext\">Conclusioni<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-9\"><a href=\"#Resources\"><span class=\"tocnumber\">5<\/span> <span class=\"toctext\">Risorse<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-10\"><a href=\"#Optional_Additional_Reading:\"><span class=\"tocnumber\">5.1<\/span> <span class=\"toctext\">Lettura aggiuntiva facoltativa:<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-11\"><a href=\"#Clinical_Resources:\"><span class=\"tocnumber\">5.2<\/span> <span class=\"toctext\">Risorse cliniche:<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-12\"><a href=\"#Optional_Additional_Videos:\"><span class=\"tocnumber\">5.3<\/span> <span class=\"toctext\">Video aggiuntivi opzionali:<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-13\"><a href=\"#References\"><span class=\"tocnumber\">6<\/span> <span class=\"toctext\">Citazioni<\/span><\/a><\/li>\n<\/ul>\n<\/div>\n<h2><span id=\"The_Respiratory_System\" class=\"mw-headline\">L&#8217;apparato respiratorio<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Modificare la sezione: Il sistema respiratorio\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;veaction=edit&amp;section=1\">modifica<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Modificare la sezione: Il sistema respiratorio\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;action=edit&amp;section=1\">modifica fonte<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 302px;\"><a class=\"image\" href=\"\/File:Respiratory_System_basic.png\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/a\/af\/Respiratory_System_basic.png\/300px-Respiratory_System_basic.png\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/a\/af\/Respiratory_System_basic.png\/450px-Respiratory_System_basic.png 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/a\/af\/Respiratory_System_basic.png\/600px-Respiratory_System_basic.png 2x\" alt=\"\" width=\"300\" height=\"225\" data-file-width=\"1024\" data-file-height=\"768\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Figura 1. Sistema respiratorio<\/p>\n<\/div>\n<\/div>\n<\/div>\n<p>L&#8217;<a title=\"Sistema respiratorio\" href=\"\/Respiratory_System\">apparato respiratorio<\/a> \u00e8 costituito dalle vie aeree, dai <a title=\"Lung Anatomy\" href=\"\/Lung_Anatomy\">polmoni<\/a> e dalle strutture muscolo-scheletriche della gabbia <a title=\"Thoracic Anatomy\" href=\"\/Thoracic_Anatomy\">toracica<\/a>. Un modo semplice per comprendere il sistema respiratorio \u00e8 quello di dividerlo in pompa muscolo-scheletrica e organo di scambio dei gas.<sup id=\"cite_ref-:0_1-0\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup> La pompa muscolo-scheletrica \u00e8 costituita dalle strutture ossee circostanti (gabbia <a title=\"Ribs\" href=\"\/Ribs\">toracica<\/a>, colonna vertebrale cervicale e toracica, zona pelvica superiore) e dai <a title=\"Muscles of Respiration\" href=\"\/Muscles_of_Respiration\">muscoli della respirazione.<\/a> L&#8217;organo di scambio dei gas si riferisce alle vie aeree che permettono il movimento dell&#8217;aria dall&#8217;esterno del corpo agli <a title=\"Alveoli\" href=\"\/Alveoli\">alveoli<\/a> e alla membrana <a title=\"Alveoli\" href=\"\/Alveoli\">alveolo-capillare<\/a>, che \u00e8 l&#8217;interfaccia specializzata tra l&#8217;aria inspirata e la circolazione.<sup id=\"cite_ref-:0_1-1\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup> La respirazione comporta lo scambio di gas tra l&#8217;atmosfera e i polmoni, i polmoni e il <a title=\"Fisiologia del sangue\" href=\"\/Blood_Physiology\">sangue<\/a> e il sangue e i tessuti del corpo. La funzione di questo apparato \u00e8 quella di mantenere l&#8217;apporto di ossigeno e l&#8217;eliminazione dell&#8217;anidride carbonica dal corpo.<sup id=\"cite_ref-:0_1-2\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup> Il malfunzionamento di uno qualsiasi dei componenti dell&#8217;apparato respiratorio pu\u00f2 rendere necessaria la <a title=\"Ventilation and Weaning\" href=\"\/Ventilation_and_Weaning\">ventilazione<\/a> meccanica.<sup id=\"cite_ref-:1_2-0\" class=\"reference\"><a href=\"#cite_note-:1-2\">(2)<\/a><\/sup><\/p>\n<p>La <a title=\"Respiratory Failure\" href=\"\/Respiratory_Failure\">disfunzione respiratoria<\/a> \u00e8 un problema comune nei pazienti in condizioni critiche nell&#8217;<a title=\"L'unit\u00e0 di terapia intensiva\" href=\"\/The_Intensive_Care_Unit\">unit\u00e0 di terapia intensiva<\/a> (ICU).<sup id=\"cite_ref-:1_2-1\" class=\"reference\"><a href=\"#cite_note-:1-2\">(2)<\/a><\/sup><sup id=\"cite_ref-:2_3-0\" class=\"reference\"><a href=\"#cite_note-:2-3\">(3)<\/a><\/sup> I pazienti in condizioni critiche nell&#8217;unit\u00e0 di terapia intensiva sono spesso confinati a letto. Questo comporta un decondizionamento generale che ha un impatto su molti sistemi dell&#8217;organismo, compreso quello respiratorio.<sup id=\"cite_ref-:0_1-3\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup> Le complicazioni polmonari, in quanto principale causa di morbidit\u00e0 ospedaliera, sono quindi molto preoccupanti nei pazienti nell&#8217;unit\u00e0 di terapia intensiva.<sup id=\"cite_ref-:0_1-4\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup> Le complicazioni pi\u00f9 comuni in seguito al riposo a letto includono la riduzione dei <a title=\"Lung Volumes\" href=\"\/Lung_Volumes\">volumi polmonari<\/a> e della velocit\u00e0 del flusso d&#8217;aria espiratorio, la diminuzione della forza dei muscoli respiratori, la riduzione della <a title=\"Conformit\u00e0 polmonare\" href=\"\/Lung_Compliance\">compliance<\/a> dei polmoni e della parete toracica e l&#8217;alterazione degli scambi gassosi.<sup id=\"cite_ref-:0_1-5\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup> Tutti questi fattori determinano un aumento del lavoro respiratorio del paziente e aumentano il rischio di sviluppare polmonite e <a title=\"Atelettasia\" href=\"\/Atelectasis\">atelettasia<\/a>. La debolezza dei muscoli respiratori e la riduzione del <a title=\"Lung Volumes\" href=\"\/Lung_Volumes\">volume respiratorio<\/a> possono compromettere il meccanismo della tosse, aumentando ulteriormente il rischio di <a class=\"mw-redirect\" title=\"Infectious Disease\" href=\"\/Infectious_Disease\">infezioni<\/a> polmonari.<sup id=\"cite_ref-:0_1-6\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup> I pazienti in terapia intensiva sono sempre a rischio di sviluppare complicazioni come la ritenzione di secrezioni, l&#8217;<a title=\"Atelettasia\" href=\"\/Atelectasis\">atelettasia<\/a>, la <a title=\"Polmonite\" href=\"\/Pneumonia\">polmonite<\/a> associata al ventilatore, la diminuzione dell&#8217;espansione polmonare, l&#8217;aumento del lavoro respiratorio, lo squilibrio tra ventilazione e perfusione, la debolezza dei muscoli inspiratori e il fallimento dello svezzamento dalla ventilazione meccanica.<sup id=\"cite_ref-:0_1-7\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><sup id=\"cite_ref-:2_3-1\" class=\"reference\"><a href=\"#cite_note-:2-3\">(3)<\/a><\/sup><sup id=\"cite_ref-:3_4-0\" class=\"reference\"><a href=\"#cite_note-:3-4\">(4)<\/a><\/sup><sup id=\"cite_ref-:4_5-0\" class=\"reference\"><a href=\"#cite_note-:4-5\">(5)<\/a><\/sup><sup id=\"cite_ref-:5_6-0\" class=\"reference\"><a href=\"#cite_note-:5-6\">(6)<\/a><\/sup><\/p>\n<h2><span id=\"Aims_of_Physiotherapy\" class=\"mw-headline\">Obiettivi della fisioterapia<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Modificare la sezione: Obiettivi della fisioterapia\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;veaction=edit&amp;section=2\">modifica<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Modificare la sezione: Obiettivi della fisioterapia\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;action=edit&amp;section=2\">fonte edit<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>La <a title=\"Respiratory Physiotherapy\" href=\"\/Respiratory_Physiotherapy\">fisioterapia respiratoria<\/a> \u00e8 essenziale per i pazienti che si trovano nell&#8217;unit\u00e0 di terapia intensiva e svolge un ruolo chiave nella prevenzione e nell&#8217;attenuazione delle complicazioni funzionali. La fisioterapia respiratoria tempestiva favorisce la clearance mucociliare, mantiene il volume polmonare, migliora l&#8217;ossigenazione e la ventilazione, elimina le secrezioni dalle vie aeree, riduce il lavoro respiratorio, migliora il reclutamento dei muscoli inspiratori e dei polmoni, prevenendo inoltre le lesioni polmonari indotte dal ventilatore (VILI), la debolezza acquisita in terapia intensiva e la sindrome post-intensiva derivante da una prolungata immobilit\u00e0. L&#8217;utilizzo di tecniche come il posizionamento posturale e la fisioterapia respiratoria garantisce un&#8217;assistenza sicura che previene attivamente potenziali danni al paziente.<sup id=\"cite_ref-7\" class=\"reference\"><a href=\"#cite_note-7\">(7)<\/a><\/sup> <sup id=\"cite_ref-8\" class=\"reference\"><a href=\"#cite_note-8\">(8)<\/a><\/sup> <sup id=\"cite_ref-:5_6-1\" class=\"reference\"><a href=\"#cite_note-:5-6\">(6)<\/a><\/sup><sup id=\"cite_ref-:6_9-0\" class=\"reference\"><a href=\"#cite_note-:6-9\">(9)<\/a><\/sup><sup id=\"cite_ref-:7_10-0\" class=\"reference\"><a href=\"#cite_note-:7-10\">(10)<\/a><\/sup> Altri obiettivi includono la massimizzazione della funzione muscoloscheletrica, la riduzione della durata della ventilazione meccanica, la facilitazione del ritorno alla funzione indipendente al momento della dimissione dall&#8217;unit\u00e0 di terapia intensiva, il miglioramento della <a title=\"Quality of Life\" href=\"\/Quality_of_Life\">qualit\u00e0 della vita<\/a> a lungo termine e la riduzione della durata della degenza nell&#8217;unit\u00e0 di terapia intensiva e in ospedale per ridurre i costi dell&#8217;assistenza.<sup id=\"cite_ref-:3_4-1\" class=\"reference\"><a href=\"#cite_note-:3-4\">(4)<\/a><\/sup><sup id=\"cite_ref-:4_5-1\" class=\"reference\"><a href=\"#cite_note-:4-5\">(5)<\/a><\/sup><sup id=\"cite_ref-11\" class=\"reference\"><a href=\"#cite_note-11\">(11)<\/a><\/sup> Gli obiettivi della fisioterapia respiratoria sono rivolti a quattro categorie chiave:<sup id=\"cite_ref-:0_1-8\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><sup id=\"cite_ref-:3_4-2\" class=\"reference\"><a href=\"#cite_note-:3-4\">(4)<\/a><\/sup><sup id=\"cite_ref-:7_10-1\" class=\"reference\"><a href=\"#cite_note-:7-10\">(10)<\/a><\/sup><sup id=\"cite_ref-:8_12-0\" class=\"reference\"><a href=\"#cite_note-:8-12\">(12)<\/a><\/sup><sup id=\"cite_ref-:9_13-0\" class=\"reference\"><a href=\"#cite_note-:9-13\">(13)<\/a><\/sup><\/p>\n<ol>\n<li>Clearance delle secrezioni delle vie aeree<\/li>\n<li>Reclutamento del volume polmonare o miglioramento dell&#8217;atelettasia<\/li>\n<li>Mantenimento\/miglioramento dell&#8217;ossigenazione<\/li>\n<li>Mantenimento\/miglioramento della <a title=\"Respiratory Muscle Training\" href=\"\/Respiratory_Muscle_Training\">forza dei muscoli inspiratori<\/a><\/li>\n<\/ol>\n<h2><span id=\"Physiotherapy_Modalities_for_Respiratory_Care\" class=\"mw-headline\">Modalit\u00e0 fisioterapiche per l&#8217;assistenza respiratoria<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Modificare la sezione: Modalit\u00e0 di fisioterapia per l'assistenza respiratoria\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;veaction=edit&amp;section=3\">modifica<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Modificare la sezione: Modalit\u00e0 di fisioterapia per l'assistenza respiratoria\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;action=edit&amp;section=3\">fonte edit<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>I fisioterapisti, nel tentativo di risolvere le difficolt\u00e0 respiratorie dei pazienti nell&#8217;unit\u00e0 di terapia intensiva, utilizzano varie modalit\u00e0 che verranno discusse in breve. Queste modalit\u00e0 saranno classificate in base al loro utilizzo.<\/p>\n<h3><span id=\"Modalities_for_Airway_Secretion_Clearance\" class=\"mw-headline\">Modalit\u00e0 per la clearance delle secrezioni delle vie aeree <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Modalities for Airway Secretion Clearance\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;veaction=edit&amp;section=4\">modifica<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Modalities for Airway Secretion Clearance\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;action=edit&amp;section=4\">fonte edit<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Le tecniche per la clearance delle vie aeree si riferiscono ai processi manuali o meccanici utilizzati per facilitare la mobilizzazione e la rimozione delle secrezioni (clearance mucociliare) dalle vie aeree.<sup id=\"cite_ref-:3_4-3\" class=\"reference\"><a href=\"#cite_note-:3-4\">(4)<\/a><\/sup><sup id=\"cite_ref-:10_14-0\" class=\"reference\"><a href=\"#cite_note-:10-14\">(14)<\/a><\/sup> Il sistema di clearance mucociliare \u00e8 normalmente molto efficiente ed efficace, ma dopo molte malattie respiratorie, complicazioni polmonari, anestesia e interventi chirurgici, viene spesso prodotto un eccesso di espettorato e i meccanismi intrinseci per la rimozione delle secrezioni possono risultare compromessi.<sup id=\"cite_ref-:3_4-4\" class=\"reference\"><a href=\"#cite_note-:3-4\">(4)<\/a><\/sup> Le tecniche per la clearance delle vie aeree comprendono:<sup id=\"cite_ref-:0_1-9\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><sup id=\"cite_ref-:2_3-2\" class=\"reference\"><a href=\"#cite_note-:2-3\">(3)<\/a><\/sup><sup id=\"cite_ref-:3_4-5\" class=\"reference\"><a href=\"#cite_note-:3-4\">(4)<\/a><\/sup><sup id=\"cite_ref-:4_5-2\" class=\"reference\"><a href=\"#cite_note-:4-5\">(5)<\/a><\/sup><sup id=\"cite_ref-:6_9-1\" class=\"reference\"><a href=\"#cite_note-:6-9\">(9)<\/a><\/sup><sup id=\"cite_ref-:8_12-1\" class=\"reference\"><a href=\"#cite_note-:8-12\">(12)<\/a><\/sup><sup id=\"cite_ref-:9_13-1\" class=\"reference\"><a href=\"#cite_note-:9-13\">(13)<\/a><\/sup><\/p>\n<ul>\n<li><a title=\"Iperinflazione manuale\" href=\"\/Manual_Hyperinflation\">Iperinflazione manuale e tramite ventilatore<\/a> (VHI)<\/li>\n<li>Posizionamento (<a title=\"Postural Drainage\" href=\"\/Postural_Drainage\">drenaggio posturale<\/a>)<sup id=\"cite_ref-:11_15-0\" class=\"reference\"><a href=\"#cite_note-:11-15\">(15)<\/a><\/sup><\/li>\n<li>Tecniche toraciche manuali (<a title=\"Percussion\" href=\"\/Percussion\">percussione<\/a>, vibrazione e scuotimento)<\/li>\n<li><a title=\"Suctioning\" href=\"\/Suctioning\">Aspirazione<\/a> delle vie aeree (aperte\/chiuse)<\/li>\n<li>Insufflazione ed espirazione (da pressione positiva a pressione negativa; dispositivo)<\/li>\n<li>Nebulizzazione<\/li>\n<li><a title=\"Active Cycle of Breathing Technique\" href=\"\/Active_Cycle_of_Breathing_Technique\">Tecnica del ciclo attivo di respirazione<\/a> (ACBT)<sup id=\"cite_ref-16\" class=\"reference\"><a href=\"#cite_note-16\">(16)<\/a><\/sup><\/li>\n<li>Tecniche di tosse assistita<\/li>\n<li>Manovra di espirazione forzata (tosse\/soffio)<\/li>\n<li><a title=\"Positive Expiratory Pressure (PEP) Devices\" href=\"\/Positive_Expiratory_Pressure_(PEP)_Devices\">Dispositivi a pressione espiratoria positiva (PEP)<\/a> come flutter, acapella<\/li>\n<\/ul>\n<p>Guardate il seguente video facoltativo della durata di 4:25 per avere una panoramica delle varie tecniche di liberazione delle vie aeree, tra cui: soffio, ciclo attivo della respirazione, drenaggio autogeno, fisioterapia toracica, giubbotto oscillante ad alta frequenza della parete toracica, dispositivi a pressione espiratoria positiva (PEP), dispositivo oscillante delle vie aeree (AOD).<\/p>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 648px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 640px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/1Ufj3oU_M2w?\" width=\"640\" height=\"360\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-17\" class=\"reference\"><a href=\"#cite_note-17\">(17)<\/a><\/sup><\/p>\n<h3><span id=\"Modalities_for_Enhancing_Lung_Volume.2FImprovement_of_Atelectasis\"><\/span><span id=\"Modalities_for_Enhancing_Lung_Volume\/Improvement_of_Atelectasis\" class=\"mw-headline\">Modalit\u00e0 per aumentare il volume polmonare\/migliorare l&#8217;<a title=\"Atelettasia\" href=\"\/Atelectasis\">atelettasia<\/a><\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Modificare la sezione: Modalit\u00e0 per l'aumento del volume polmonare\/miglioramento dell'atelettasia\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;veaction=edit&amp;section=5\">modifica<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Modificare la sezione: Modalit\u00e0 per l'aumento del volume polmonare\/miglioramento dell'atelettasia\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;action=edit&amp;section=5\">modifica fonte<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 302px;\"><a class=\"image\" href=\"\/File:Atelectasis_and_blockage.png\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/9\/96\/Atelectasis_and_blockage.png\/300px-Atelectasis_and_blockage.png\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/9\/96\/Atelectasis_and_blockage.png\/450px-Atelectasis_and_blockage.png 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/9\/96\/Atelectasis_and_blockage.png\/600px-Atelectasis_and_blockage.png 2x\" alt=\"\" width=\"300\" height=\"220\" data-file-width=\"1200\" data-file-height=\"880\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Figura 2. Atelettasia<\/p>\n<\/div>\n<\/div>\n<\/div>\n<p>Le seguenti modalit\u00e0 possono essere utilizzate per aumentare il volume polmonare o migliorare l&#8217;atelettasia (vedi figura 2):<sup id=\"cite_ref-:0_1-10\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><sup id=\"cite_ref-:3_4-6\" class=\"reference\"><a href=\"#cite_note-:3-4\">(4)<\/a><\/sup><sup id=\"cite_ref-:6_9-2\" class=\"reference\"><a href=\"#cite_note-:6-9\">(9)<\/a><\/sup><sup id=\"cite_ref-:8_12-2\" class=\"reference\"><a href=\"#cite_note-:8-12\">(12)<\/a><\/sup><\/p>\n<ul>\n<li>Posizionamento (in decubito laterale con il lato interessato rivolto verso l&#8217;alto)<sup id=\"cite_ref-:11_15-1\" class=\"reference\"><a href=\"#cite_note-:11-15\">(15)<\/a><\/sup><\/li>\n<li>Iperinflazione manuale e tramite ventilatore<\/li>\n<li><a title=\"Esercizi di respirazione\" href=\"\/Breathing_Exercises\">Esercizi di respirazione profonda<\/a> (respirazione segmentale e contro resistenza)<\/li>\n<li><a title=\"Spirometria incentiva\" href=\"\/Incentive_Spirometry\">Spirometria incentivante<\/a> (IS)<\/li>\n<li>Pressione positiva di fine espirazione (PEEP)<\/li>\n<li>Active Cycle of Breathing Technique<\/li>\n<li><a title=\"Breath Stacking\" href=\"\/Breath_Stacking\">Breath Stacking<\/a><\/li>\n<li>Esercizi di espansione toracica (TEE)<\/li>\n<li>Rib springing<\/li>\n<li>Scuotimenti e vibrazioni manuali della parete toracica<\/li>\n<li><a title=\"Intermittent positive pressure breathing\" href=\"\/Intermittent_positive_pressure_breathing\">Respirazione a pressione positiva intermittente<\/a> (IPPB)<\/li>\n<li><a title=\"Ventilazione non invasiva\" href=\"\/Non_Invasive_Ventilation\">Ventilazione non invasiva<\/a> (NIV) e CPAP<\/li>\n<\/ul>\n<p>Per una panoramica sulla ventilazione non invasiva e sui dispositivi CPAP, guardate il seguente video facoltativo della durata di 4:34.<\/p>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 648px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 640px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/OHQK5PUTQ_0?\" width=\"640\" height=\"360\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-18\" class=\"reference\"><a href=\"#cite_note-18\">(18)<\/a><\/sup><\/p>\n<h3><span id=\"Modalities_for_Improvement_of_Oxygenation_.28Gas_exchange.29\"><\/span><span id=\"Modalities_for_Improvement_of_Oxygenation_(Gas_exchange)\" class=\"mw-headline\">Modalit\u00e0 per migliorare l&#8217;ossigenazione (scambio di gas)<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Modificare la sezione: Modalit\u00e0 per il miglioramento dell'ossigenazione (scambio di gas)\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;veaction=edit&amp;section=6\">modifica<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Modificare la sezione: Modalit\u00e0 per il miglioramento dell'ossigenazione (scambio di gas)\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;action=edit&amp;section=6\">fonte edit<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<ul>\n<li>Posizionamento<\/li>\n<li>Ventilazione non invasiva (pressione positiva continua delle vie aeree (CPAP), dispositivi per la respirazione a pressione positiva intermittente (IPPB), BiPAP, VPAP)<\/li>\n<li>Iperinflazione manuale o tramite ventilatore<\/li>\n<li>Breath Stacking<\/li>\n<li>Esercizi di respirazione profonda<\/li>\n<li>Esercizi di espansione toracica (TEE) <sup id=\"cite_ref-:0_1-11\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><sup id=\"cite_ref-:3_4-7\" class=\"reference\"><a href=\"#cite_note-:3-4\">(4)<\/a><\/sup><sup id=\"cite_ref-:6_9-3\" class=\"reference\"><a href=\"#cite_note-:6-9\">(9)<\/a><\/sup><sup id=\"cite_ref-:8_12-3\" class=\"reference\"><a href=\"#cite_note-:8-12\">(12)<\/a><\/sup><\/li>\n<\/ul>\n<h3><span id=\"Modalities_to_Maintain_or_Improve_Inspiratory_Muscle_Strength\" class=\"mw-headline\">Modalit\u00e0 per mantenere o migliorare la forza dei muscoli inspiratori<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Modificare la sezione: Modalit\u00e0 per mantenere o migliorare la forza muscolare inspiratoria\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;veaction=edit&amp;section=7\">modifica<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Modificare la sezione: Modalit\u00e0 per mantenere o migliorare la forza muscolare inspiratoria\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;action=edit&amp;section=7\">fonte edit<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<ul>\n<li>Allenamento dei muscoli inspiratori ed espiratori<sup id=\"cite_ref-19\" class=\"reference\"><a href=\"#cite_note-19\">(19)<\/a><\/sup><\/li>\n<li>Dispositivi per <a title=\"Respiratory Muscle Training\" href=\"\/Respiratory_Muscle_Training\">l&#8217;allenamento dei muscoli inspiratori<\/a> (dispositivo Threshold\u00ae IMT a molla o POWERbreathe\u00ae)<\/li>\n<li>Spirometria incentiva<\/li>\n<li>Resistenza manuale della parete toracica <sup id=\"cite_ref-:0_1-12\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><sup id=\"cite_ref-:3_4-8\" class=\"reference\"><a href=\"#cite_note-:3-4\">(4)<\/a><\/sup><sup id=\"cite_ref-:10_14-1\" class=\"reference\"><a href=\"#cite_note-:10-14\">(14)<\/a><\/sup><\/li>\n<\/ul>\n<h2><span id=\"Conclusion\" class=\"mw-headline\">Conclusione<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Conclusion\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;veaction=edit&amp;section=8\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Conclusion\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;action=edit&amp;section=8\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Una valutazione continua \u00e8 essenziale durante il trattamento dei pazienti in condizioni critiche nell&#8217;unit\u00e0 di terapia intensiva. I risultati della valutazione sono inoltre ci\u00f2 che orienta il fisioterapista verso il trattamento pi\u00f9 appropriato. I costanti cambiamenti nelle condizioni fisiologiche, motivazionali ed emotive del paziente nel reparto di terapia intensiva richiedono inoltre che il piano di cura sia flessibile.<sup id=\"cite_ref-:0_1-13\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup> La fisioterapia respiratoria svolge un ruolo importante nel reparto di terapia intensiva, ma \u00e8 importante ricordare che il ruolo del fisioterapista in nel reparto di terapia intensiva non si limita solo alla gestione respiratoria, ma si estende anche alla <a title=\"Mobilizzazione precoce in terapia intensiva\" href=\"\/Early_Mobilization_in_the_ICU\">mobilizzazione<\/a> e alla <a title=\"Contesti di riabilitazione\" href=\"\/Rehabilitation_Contexts\">riabilitazione<\/a>, che a loro volta avranno un impatto diretto sul sistema respiratorio.<\/p>\n<h2><span id=\"Resources\" class=\"mw-headline\">Risorse<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Resources\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;veaction=edit&amp;section=9\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Resources\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;action=edit&amp;section=9\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<h5><span id=\"Optional_Additional_Reading:\" class=\"mw-headline\">Lettura aggiuntiva facoltativa:<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Optional Additional Reading:\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;veaction=edit&amp;section=10\">modifica<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Optional Additional Reading:\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;action=edit&amp;section=10\">modifica fonte<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h5>\n<ul>\n<li>Ols\u00e9n MF, Lannefors L, Westerdahl E. <a class=\"external text\" href=\"https:\/\/pdf.sciencedirectassets.com\/272432\/1-s2.0-S0954611115X00035\/1-s2.0-S0954611114003916\/main.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEK7%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEaCXVzLWVhc3QtMSJHMEUCIGh7J%2F%2B4vX9drTSNXcCnlNFmK5Cmqq1KGomnpOIFvHY%2BAiEA9lHvZDx%2Fe37WqDAbYrQr1GqQAXdnTjzoqij5LCh0zQ4qswUIVxAFGgwwNTkwMDM1NDY4NjUiDDwNJvjBiXfbV9WkuCqQBfWqF8iAuSw7j%2Fs9oOJrnLxd9KJmcIW%2FRH%2BmPl1hXWn8vFZr96v%2FU6DM2Zdckcou81cJDqwC5COY0ZJO4QKseRHYlLaYVKRDT6NtuxLZkEWoOA9twb2c19CuqzYFPTxATaO9X%2BU2%2BZeOFaE61tI1LmokttaT48AF1%2FeTB3M5HGkck7uii6fyEpcdARdTKQ%2Bj2hLz7SzVGWQrGZnD%2Fi9H5PShjtG%2Fzv8ItUdnIt6CPTTzb27sNAi9p7IwwUUVg79Y4ha7xQ%2BypnRWNvCs279IuGA64Pz9Y2jX%2FHg%2Bu1MIQze5VeguChMkNQiOxkcpFsoSRdGv35bPkFEXB71KMq40EsgM78lT0WCRyHP8veDoaO2IWusRCkKRtZOHMFfMMK502T7ecIgzSFQy3cn4lpQcEfRioSQNziTf2U1E9GApSc2FPELxeszVVBoBcOY07rr5XACp%2BHntqR5pW3LJk7J8GFrgTVWMP4c%2F9V6SxMDjH6waxlNe80krumOuRccd5T%2BLDBZKZ7edDqnWcXc2Iu1%2FDqYMpOJ2F7xkL3rInloi5zS2h7B%2BfEOrb4mi1wwpeWBSt9sk2aCMP9LqVqwqCkhBXNvnvJTSL86Wb%2F3jyNr%2F74goiZIfgOcd%2BXqfDn%2B8peP5kFEAlD9gfRML9oyQRHfVYVQjX2%2F5s%2FGTSbFOhPI2m4WCrDyocxh%2BrGWhYog2f2IRKsDLJdZyOknikqsppls51M4gaL1PNPtzxKMkAVvZu5%2Fgs26RgF5H%2FyEfYAIXCW4GjKgdjUlzcAr1O6QDTDsU2PzFYC2w3g3Xmm80DVNpUs%2F7W7rgTUmJFm5%2B3Es0O3iKTjxjhP6Vra3s026FJ%2FN2HFG6Aqmnl4Leq%2BKisgrGTOuzMMai1LMGOrEBUEWjSnCyK59rzsf1KnTAbQvP3gXYx73U%2Fm%2FBAMgfGhizb0QhQ9TLjfSTvMJsUV5HYcVNg08MZyXzM43aXzjVDGIBsKBNHAlPTbq6Q3gObT67AWJwh5b1cSd%2FI56Sh8C18qtMBx4OIGdvDt8kUfQct36Gyz2TNK7E5aLxiRhF0lW26Ry2Jn1q67JsKN9ab2bSKe0SkmFtGhBLo8vPjr%2FGkEzNPujvVlZQbMohNkz4QkVM&amp;X-Amz-Algorithm=AWS4-HMAC-SHA256&amp;X-Amz-Date=20240621T054634Z&amp;X-Amz-SignedHeaders=host&amp;X-Amz-Expires=300&amp;X-Amz-Credential=ASIAQ3PHCVTYX3FRN7FF%2F20240621%2Fus-east-1%2Fs3%2Faws4_request&amp;X-Amz-Signature=df362e6488b9093284a79b49d671bd02811cadb58a632b02763825ebac9cf169&amp;hash=21ed1a4a01e75ab5fb47b2c496274c9c9c309fa46c7f8f503a7fe65798e7c47c&amp;host=68042c943591013ac2b2430a89b270f6af2c76d8dfd086a07176afe7c76c2c61&amp;pii=S0954611114003916&amp;tid=spdf-b7ac45af-dca2-4c8c-bd7f-d27d6c76e11f&amp;sid=b00fb8f41b86a9447899bf361e6d96bd08cagxrqa&amp;type=client&amp;tsoh=d3d3LnNjaWVuY2VkaXJlY3QuY29t&amp;ua=13135f5e575e04530502&amp;rr=8971b2ee2b3aa982&amp;cc=us\" rel=\"nofollow\">Positive expiratory pressure\u2013common clinical applications and physiological effects<\/a>. Respiratory medicine. 2015 Mar 1;109(3):297-307.<\/li>\n<\/ul>\n<h5><span id=\"Clinical_Resources:\" class=\"mw-headline\">Risorse cliniche:<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Clinical Resources:\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;veaction=edit&amp;section=11\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Clinical Resources:\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;action=edit&amp;section=11\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h5>\n<ul>\n<li><a class=\"external text\" href=\"https:\/\/www.merckmanuals.com\/professional\/pulmonary-disorders\/pulmonary-rehabilitation\/chest-physiotherapy\" rel=\"nofollow\">Controindicazioni alla fisioterapia respiratoria (toracica)<\/a><\/li>\n<li>Esempio di <a class=\"external text\" href=\"https:\/\/www.merckmanuals.com\/home\/lung-and-airway-disorders\/rehabilitation-for-lung-and-airway-disorders\/chest-physical-therapy\" rel=\"nofollow\">foglio di istruzione per il paziente<\/a><\/li>\n<li>Ecco una raccolta di varie <a class=\"external text\" href=\"https:\/\/www.aarc.org\/resource\/clinical-practice-guidelines\/\" rel=\"nofollow\">linee guida per il trattamento con terapia respiratoria<\/a> (a cura dell&#8217;American Association of Respiratory Care)<\/li>\n<\/ul>\n<h5><span id=\"Optional_Additional_Videos:\" class=\"mw-headline\">Video aggiuntivi facoltativi:<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Optional Additional Videos:\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;veaction=edit&amp;section=12\">modifica<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Optional Additional Videos:\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;action=edit&amp;section=12\">modifica fonte<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h5>\n<p>Di seguito troverete una raccolta di brevi video di tecniche di fisioterapia respiratoria per approfondire le vostre conoscenze delle potenziali modalit\u00e0 di trattamento e degli interventi utili per i pazienti nell&#8217;unit\u00e0 di terapia intensiva. Come per qualsiasi tecnica di trattamento avanzata, prima di provare questi interventi sui pazienti \u00e8 consigliabile seguire una formazione pratica aggiuntiva e dimostrare le proprie competenze.<\/p>\n<ul>\n<li>Questo video mostra le opzioni di posizionamento per il drenaggio dei diversi lobi dei polmoni.<\/li>\n<\/ul>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 308px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 300px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/LJU_zVMnF3o?\" width=\"300\" height=\"169\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-20\" class=\"reference\"><a href=\"#cite_note-20\">(20)<\/a><\/sup><\/p>\n<ul>\n<li>Questo video mostra le tecniche di cupping e di terapia manuale percussiva.<\/li>\n<\/ul>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 308px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 300px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/1ZRk55sHJ1I?\" width=\"300\" height=\"169\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-21\" class=\"reference\"><a href=\"#cite_note-21\">(21)<\/a><\/sup><\/p>\n<ul>\n<li>Questo video mostra le tecniche di tosse assistita.<\/li>\n<\/ul>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 308px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 300px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/SN6CrBdM_IU?\" width=\"300\" height=\"169\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-22\" class=\"reference\"><a href=\"#cite_note-22\">(22)<\/a><\/sup><\/p>\n<ul>\n<li>Questo video mostra le tecniche di respirazione a labbra chiuse.<\/li>\n<\/ul>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 308px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 300px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/7kpJ0QlRss4?\" width=\"300\" height=\"169\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-23\" class=\"reference\"><a href=\"#cite_note-23\">(23)<\/a><\/sup><\/p>\n<ul>\n<li>Questo video mostra il soffio e l&#8217;uso della PEP.<\/li>\n<\/ul>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 308px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 300px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/cMM9IZ0wlMw?\" width=\"300\" height=\"169\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-24\" class=\"reference\"><a href=\"#cite_note-24\">(24)<\/a><\/sup><\/p>\n<ul>\n<li>I due video seguenti mostrano le tecniche di ciclo attivo della respirazione.<\/li>\n<\/ul>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 308px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 300px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/XvorhwGZGm8?\" width=\"300\" height=\"169\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-25\" class=\"reference\"><a href=\"#cite_note-25\">(25)<\/a><\/sup><\/p>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 308px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 300px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/4mXBcA6AI_4?\" width=\"300\" height=\"169\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-26\" class=\"reference\"><a href=\"#cite_note-26\">(26)<\/a><\/sup><\/p>\n<ul>\n<li>Il seguente video, della durata di 13:33, fornisce una spiegazione pi\u00f9 approfondita dei volumi e delle capacit\u00e0 polmonari.<\/li>\n<\/ul>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 648px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 640px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/KnNkqH3-1SU?\" width=\"640\" height=\"360\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-27\" class=\"reference\"><a href=\"#cite_note-27\">(27)<\/a><\/sup><\/p>\n<h2><span id=\"References\" class=\"mw-headline\">Citazioni<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: References\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;veaction=edit&amp;section=13\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: References\" href=\"\/index.php?title=Respiratory_Physiotherapy_for_ICU_Patients&amp;action=edit&amp;section=13\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<div class=\"mw-references-wrap mw-references-columns\">\n<ol class=\"references\">\n<li id=\"cite_note-:0-1\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:0_1-0\">1.00<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-1\">1.01<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-2\">1.02<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-3\">1.03<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-4\">1.04<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-5\">1.05<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-6\">1.06<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-7\">1.07<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-8\">1.08<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-9\">1.09<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-10\">1.10<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-11\">1.11<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-12\">1.12<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-13\">1.13<\/a><\/sup><\/span> <span class=\"reference-text\">Malone DJ, Bishop KL. <a class=\"external text\" href=\"https:\/\/search.ebscohost.com\/login.aspx?direct=true&amp;db=nlebk&amp;AN=2513712&amp;site=ehost-live\" rel=\"nofollow\">Acute Care Physical Therapy : A Clinician\u2019s Guide<\/a>, Second Edition (Internet). Vol. Second edition. Thorofare, NJ: SLACK Incorporated; 2020 (cited 2021 Mar 5). <\/span><\/li>\n<li id=\"cite_note-:1-2\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:1_2-0\">2.0<\/a><\/sup> <sup><a href=\"#cite_ref-:1_2-1\">2.1<\/a><\/sup><\/span> <span class=\"reference-text\">Gosselink R, Roeseler J. <a class=\"external text\" href=\"https:\/\/www.researchgate.net\/profile\/Rik-Gosselink\/publication\/300609219_Chapter_32_Physiotherapy_in_critically_ill_patients\/links\/5b2aa631aca27209f379600f\/Chapter-32-Physiotherapy-in-critically-ill-patients.pdf\" rel=\"nofollow\">Physiotherapy in critically ill patients<\/a>. The ESC Textbook of Intensive and Acute Cardiovascular Care. 2015 Feb 26:284. <\/span><\/li>\n<li id=\"cite_note-:2-3\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:2_3-0\">3.0<\/a><\/sup> <sup><a href=\"#cite_ref-:2_3-1\">3.1<\/a><\/sup> <sup><a href=\"#cite_ref-:2_3-2\">3.2<\/a><\/sup><\/span> <span class=\"reference-text\">Connolly B, Barclay M, Blackwood B, Bradley J, Anand R, Borthwick M, et al. Airway clearance techniques and use of mucoactive agents for adult critically ill patients with acute respiratory failure: a qualitative study exploring UK physiotherapy practice. Physiotherapy. 2020;108:78-87. <\/span><\/li>\n<li id=\"cite_note-:3-4\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:3_4-0\">4.0<\/a><\/sup> <sup><a href=\"#cite_ref-:3_4-1\">4.1<\/a><\/sup> <sup><a href=\"#cite_ref-:3_4-2\">4.2<\/a><\/sup> <sup><a href=\"#cite_ref-:3_4-3\">4.3<\/a><\/sup> <sup><a href=\"#cite_ref-:3_4-4\">4.4<\/a><\/sup> <sup><a href=\"#cite_ref-:3_4-5\">4.5<\/a><\/sup> <sup><a href=\"#cite_ref-:3_4-6\">4.6<\/a><\/sup> <sup><a href=\"#cite_ref-:3_4-7\">4.7<\/a><\/sup> <sup><a href=\"#cite_ref-:3_4-8\">4.8<\/a><\/sup><\/span> <span class=\"reference-text\">Main E, Denehy L, editors. Cardiorespiratory Physiotherapy: Adults and Paediatrics E-Book: formerly Physiotherapy for Respiratory and Cardiac Problems. 5th ed. Elsevier Health Sciences; 2016 Jun 7.<\/span><\/li>\n<li id=\"cite_note-:4-5\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:4_5-0\">5.0<\/a><\/sup> <sup><a href=\"#cite_ref-:4_5-1\">5.1<\/a><\/sup> <sup><a href=\"#cite_ref-:4_5-2\">5.2<\/a><\/sup><\/span> <span class=\"reference-text\">\u00c7akmak A, \u0130nce D\u0130, Sa\u011flam M, Savc\u0131 S, Ya\u011fl\u0131 NV, K\u00fct\u00fckc\u00fc E\u00c7, et al. <a class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6453635\/pdf\/ttj-20-2-114.pdf\" rel=\"nofollow\">Physiotherapy and Rehabilitation Implementation in Intensive Care Units: A Survey Study<\/a>. Turkish thoracic journal. 2019;20(2):114. <\/span><\/li>\n<li id=\"cite_note-:5-6\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:5_6-0\">6.0<\/a><\/sup> <sup><a href=\"#cite_ref-:5_6-1\">6.1<\/a><\/sup><\/span> <span class=\"reference-text\">Spapen HD, De Regt J, Honor\u00e9 PM. <a class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5303101\/pdf\/jtd-09-01-E44.pdf\" rel=\"nofollow\">Chest physiotherapy in mechanically ventilated patients without pneumonia\u2014a narrative review.<\/a> Journal of thoracic disease. 2017;9(1): E44. <\/span><\/li>\n<li id=\"cite_note-7\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-7\">\u2191<\/a><\/span> <span class=\"reference-text\">Arriagada R, Bachmann MC, San Martin C, Rauseo M, Battaglini D. Electrical impedance tomography: Usefulness for respiratory physiotherapy in critical illnesses. 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