重症监护室患者的安全性和早期动员:对随机对照试验的更新系统审查和元分析
Syed A Khan1, Abdul Moeed2, Tahreem Mari3
1Department of Critical Care Medicine, Mayo Clinic Health System, Mankato, MN 56001, United States.
World journal of critical care medicine
|December 11, 2025
概括
在ICU入院后72小时内进行早期动员 (EM) 可以显著减少重症监护室 (ICU) 停留时间和通风时间. 这种方法还可以改善重症患者的肌肉强度和功能状态.
科学领域:
- 关键护理医学 关键护理医学
- 康复科学 康复科学 康复科学
- 基于证据的实践.
背景情况:
- 在ICU中长时间的不运动会导致肌肉缩和长时间的恢复.
- 在ICU入院后一周内动员,对身体功能有潜在的益处.
研究的目的:
- 评估在ICU入院72小时内启动早期动员 (EM) 的影响.
- 在重症患者中对EM进行更新的系统审查和元分析.
主要方法:
- 在MEDLINE,Scopus和Cochrane图书馆进行系统搜索,直到2024年9月.
- 包括16项随机对照试验 (RCT),涉及2385名严重病情严重的成年患者.
- 随机效应的元分析,以对主要和次要结果的效应估计进行汇总.
主要成果:
- 早期动员显著减少了ICU停留时间 (MD = -1.02天) 和通风持续时间 (MD = -1.07天).
- 肌肉强度 (SMD = 0.47) 和功能状态 (SMD = 0.70) 显著改善.
- 在不良事件,全因死亡率或生活质量方面没有发现显著差异.
结论:
- 在ICU入院72小时内启动动动员,可以改善功能结果,减少ICU停留和通风时间.
- 早期动员似乎是ICU患者的安全干预,可能降低康复时间和医疗费用.
- 需要进一步的研究来证实对生存和生活质量的长期影响.
相关概念视频
Acute Coronary Syndrome IV: Interprofessional Care
197
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
197
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
277
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
277
Acute Coronary Syndrome V: Nursing Management
247
Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
247

