结构化协议化物理治疗对延长断奶患者机械通风持续时间的影响
Johannes Bickenbach1, Sebastian Fritsch1, Sophia Cosler1
1Department of Intensive and Intermediate Care, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Journal of critical care
|December 2, 2023
概括
实施结构化物理治疗计划显著减少了长期断奶患者的机械通风 (MV) 持续时间. 这种方法改善了肌肉强度和患者的结果,包括生存率.
科学领域:
- 关键护理医学 关键护理医学
- 物理疗法物理治疗
- 呼吸系统护理 呼吸系统护理
背景情况:
- 长时间的机械通风 (MV) 影响了20%的ICU患者,导致ICU获得的虚弱 (ICUAW) 和不良预后.
- ICUAW涉及显著的肌肉功能障碍,使奶过程复杂化,并影响患者的长期康复.
研究的目的:
- 在需要长时间机械通风的患者中,评估一项协议化,系统化的物理治疗方法的有效性.
- 为了确定这种结构化的物理治疗计划是否可以缩短机械通风断奶的持续时间.
主要方法:
- 一项比较性研究包括长期断奶的ICU患者,分为干预前组 (组1) 和干预后组 (组2) 进行结构化物理治疗计划.
- 测量的主要结果是手握强度和外科重症监护室最佳动员分数 (SOMS). 二次结局包括断奶成功,无呼吸器日,死亡率,ICUAW患病率,感染和妄想.
主要成果:
- 结构化物理治疗计划显著改善了SOMS和手握强度.
- 2组 (使用该计划) 的患者经历了显著更短的MV持续时间.
- 第二组也显示出感染的发病率较低,存活的可能性更高,尽管退院时断奶成功率没有差异.
结论:
- 协议化,有系统的物理治疗显然改善了从机械通风中长期断奶的患者的临床结果.
- 这种方法的好处可以通过SOMS和手握强度测试等工具客观地测量.
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