Aspinall V, Capello M Canine and feline anatomy and physiology, 4th Edition. In: Lane D, Cooper B, Turner L Gloucester: British Small Animal Veterinary Association; 2007

Calvo G Rehabilitation nursing goals.Gloucester: British Small Animal Veterinary Association; 2012

Carver D Respiratory conditions: Case studies.Gloucester: British Small Animal Veterinary Association; 2012

Clini E, Ambrosino N Early physiotherapy in the respiratory intensive care unit. Respir Med. 2005; 99:1096-104

Collard HR Prevention of ventilator-assisted pneumonia: an evidenced-based systematic review. Annals Intern Med. 2003; 138:494-501

Cook N Respiratory care in spinal cord injury with associated traumatic brain injury: bridging the gap in critical care nursing intervention. Intensive Crit Care Nurs. 2003; 19:143-53

Coyer FM, Wheeler MK, Etzig SM, Couchman BA Nursing care of the mechanically ventilated patient: What does the evidence say? Part two. Intensive Crit Care Nurs. 2007; 23:71-80

Eom K, Seong Y, Park H, Choe N, Park J, Jang K Radiographic and computed tomographic evaluation of experimentally induced lung aspiration sites in dogs. J Vet Sci. 2006; 7:(4)397-9

Foster WM Mucociliary Transport and Cough in Humans. Pulm Pharmacol Ther. 2002; 15:277-82

Frogley S Nursing the neurology patient. Veterinary Nursing Times. 2011; 11:(12)10-12

Garrod R, Lasserson T Role of physiotherapy in the management of chronic lung diseases: An overview of systematic reviews. Respir Med. 2007; 101:2429-36

Guimarães FS, Zin WA Thoracic percussion yields reversible change in healthy subjects'. European Journal of Applied Physiology. 2008; 104:(4)601-607

Hess D Patient Positioning and Ventilator-Associated Pneumonia. Respiratory Care. 2005; 50:(7)892-8

March A A review of respiratory management in spinal cord injury. Journal of Orthopaedic Nursing. 2005; 9:19-26

McMillan MW, Whitaker KE, Brodbelt DC, Boag AK Effect of body position on the arterial partial pressure of oxygen and carbon dioxide in spontaneously breathing, conscious dogs in an intensive care unit. J Vet Emerg Crit Care. 2009; 19:(6)564-70

Orpet H, Welsh POxford: Wiley-Blackwell; 2011

Park EH, White GA, Tieber LM Mechanisms of injury and emergency care of acute spinal injury in dogs and cats. J Vet Emerg Crit Care. 2012; 22:(2)160-78

Rogers D, Doull IJM Physiological principles of airway clearance techniques used in the physiotherapy management of Cystic Fibrosis. Current Paediatrics. 2005; 15:233-8

Schilero GJ, Spungen AM, Bauman WA, Radulovic M, Lesser M Pulmonary function and spinal cord injury. Respir Physiol Neurobiol. 2009; 166:129-41

Shannon H, Gregson R, Stocks J, Cole TJ, Main E Repeatability of physiotherapy chest wall vibrations applied to spontaneously breathing adults. Physiotherapy. 2009; 95:36-43

Sharp B Physiotherapy and rehabilitation. In: Hotson-Moore A, Ruda S Gloucester: British Small Animal Veterinary Association; 2008

Thomas PJ, Paratz JD, Stanton WR, Deans R, Lipman J Positioning practices for ventilated intensive care patients: current practice, indications and contraindications. Aust Crit Care. 2006; 19:(4)122-32

Thomas PJ, Paratz JD, Lipman J, Stanton WR Lateral positioning of ventilated intensive care patients: A study of oxygenation, respiratory mechanics, hemodynamics, and adverse events. Heart & Lung. 2007; 36:(4)277-86

Thompson J Improving continuity of care. Veterinary Nursing Journal. 2009; 24:(8)33-5

Treacy K, Tunney M, Elborn JS, Bradley JM Mucociliary clearance in cystic fibrosis: physiology and pharmacological treatments. Paediatric and Child Health. 2011; 21:(9)425-30

Vollman KM The right position at the right time: mobility makes a difference. Intensive Crit Care Nurs. 2004; 20:179-82

Wong WP, Paratz JD, Wilson K, Burns YR Hemodynamic and ventilator effects of manual respiratory physiotherapy techniques of chest clapping, vibration and shaking in an animal model. J Appl Physiol. 2003; 95:(3)991-8

Whitney J, Harden B, Keilty S Assisted cough. Physiotherapy. 2002; 88:(4)201-7

Recumbent patients: is turning enough?

02 November 2015
10 mins read
Volume 6 · Issue 9


Recumbency in patients can be challenging in veterinary practice, and further understanding of the care that these dependent patients require can be potentially further improved. Patients are seen for complex disease processes and the advances in veterinary medicine have allowed for impressive intensive care to be achieved, and the ability for gold standard nursing care which demands further research into this field. To enable care to be of the highest standard, and to ensure recumbent patients nursing care is maintained to the gold standard while hospitalised, informed, knowledgeable and trained registered veterinary nurses (RVNs) should be advised on the appropriate nursing interventions to be applied to promote quicker recovery from disease. Maintaining patent respiratory function is a necessity with recumbent patients to facilitate recovery from disease processes.

Recumbency, normally due to processes such as pulmonary disease or thoracic wall disease, rib fractures, ventilated patients, trauma or surgical intervention, does not allow the patient to carry out normal daily activities. One of the main concerns in recumbent patients is respiratory function, the ability to maintain a healthy airway and provide good oxygenation while recovering. With limited research in the veterinary field involving recumbency, this article reviews both veterinary and human literature.

The primary function and ability of the lung is to enable gaseous exchange, allowing air distribution within the lobes to match the perfusion of the body's tissues (Schilero et al, 2009). Altering body position of challenged patients with disease processes, alters biomechanical homeostasis (Vollman, 2004), subsequently requiring nursing interventions (NIs). Turning patients into variable positions and providing physical therapies are advised (Frownfelter and Dean, 2012). Clini and Ambrosino (2005) stated that early physiotherapy in human patients is cost effective, improves residual function, reduces the need for future admissions and improves quality of life. Physiotherapy is believed to restore respiratory function, ventilatory dependence, and reduce the risk of bed-rest complications. Therapy has been documented for strengthening the chest, lungs and stomach, initially by using deep breathing and postural exercises (Garrod and Lasserson, 2007). Change in posture is believed to decrease the incidence of further diseases developing, such as pneumonia, consolidation of lung lobes and atelectasis (Cook, 2003). Turning is a recognised technique, but current research into additional therapies has been controversial and spartan particularly in veterinary medicine, and postural exercises are difficult to replicate in veterinary patients.

Register now to continue reading

Thank you for visiting The Veterinary Nurse and reading some of our peer-reviewed content for veterinary professionals. To continue reading this article, please register today.