在机械通风患者的早期卧床循环人体工程学
Michelle E Kho1,2, Susan Berney3,4, Amy M Pastva5
1School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
NEJM evidence
|June 12, 2024
概括
早期在床上骑自行车加上物理治疗并没有改善机械通风ICU患者的身体功能. 这种干预是安全的,没有引起严重的不良事件,但没有提高康复结果.
科学领域:
- 关键护理医学 关键护理医学
- 康复 康复 康复 康复
- 物理治疗是物理治疗.
背景情况:
- 在危急疾病中,机械通风可以导致显著的功能障碍和发病率.
- 早期康复干预,如床上循环人体工程学,正在探索以减轻重症监护室 (ICU) 获得的损伤.
- 通常的物理治疗是这些患者护理的标准组成部分.
研究的目的:
- 为了确定早期的床上骑自行车运动,当添加到通常的物理治疗时,改善了机械呼吸的成年ICU患者的身体功能.
- 评估早期床上骑自行车作为辅助治疗的安全性和有效性.
主要方法:
- 一项随机对照试验,涉及360名入侵性机械通风的成年ICU患者.
- 患者被分配到早期的床上循环 + 常规物理治疗或仅仅是常规物理治疗.
- 主要结局是身体功能ICU测试得分 (PFIT-s) 测量在ICU出院3天后.
主要成果:
- 循环干预开始于机械通风启动后的平均2天内.
- 在干预组或对照组中没有报告严重不良事件.
- 在ICU出院后3天的PFIT平均得分在两组之间相似 (7.7比7.5),没有统计学上显著的差异 (P=0.29).
结论:
- 在通常的物理治疗中添加早期的床上循环并没有显著改善机械通风ICU幸存者的身体功能.
- 干预措施是安全的,耐受性很好,没有严重的不良事件.
- 可能需要进一步的研究来探索不同的协议或患者群体.
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