对严重后天性脑损伤和气管切开术患者进行高频敲击的可行性:一项观察性研究。

IF 1.1 Q4 RESPIRATORY SYSTEM Monaldi Archives for Chest Disease Pub Date : 2024-01-17 DOI:10.4081/monaldi.2024.2734
Salvatore Andrea Sciurello, Francesca Graziano, Maria Marcella Laganà, Elena Compalati, Gabriele Pappacoda, Simone Gambazza, Jorge Navarro, Pietro Cecconi, Francesca Baglio, Paolo Banfi
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引用次数: 0

摘要

严重后天性脑损伤患者(pwSABI)经常会出现肺部并发症。其中,肺不张可因肺炎而发生,从而增加急性呼吸衰竭的发病几率。呼吸物理治疗在治疗后天性脑损伤患者肺不张方面的作用还鲜为人知。我们对 2018 年 9 月至 2021 年 2 月期间在米兰 "S.Maria Nascente - Fondazione Don Gnocchi "IRCCS 神经康复中心住院并接受高频叩击物理治疗的 15 名气管切开、自主呼吸的非合作性 pwSABI 患者进行了回顾性分析。我们的主要目的是研究这种物理治疗干预方法的可行性。然后,我们评估了物理治疗前后呼吸测量(动脉血气分析和夜间外周血氧饱和度)和高分辨率计算机断层扫描肺部图像的变化。放射学测量指标包括由两名放射科医生分配的改良放射学肺不张评分(mRAS),以及由 CT Pneumonia Analysis® 软件自动提供的不透明评分,该软件可识别肺部异常形态区域。治疗日记显示,所有治疗均已完成,治疗期间未出现任何不良反应。在分析的 15 例 pwSABI 中,8 例使用了 IPV®,7 例使用了 MetaNeb®。经过中位数为 14 天(I-III 四分位数=12.5-14.5)的治疗后,我们观察到各种动脉血气测量值和外周夜间血氧饱和度测量值均有明显改善。我们还发现 80% 以上的 pwSABI 在放射学方面有所改善或趋于稳定。总之,我们的物理治疗方法是可行的,而且我们观察到了呼吸参数和放射学方面的改善。使用技术来评估异常断层扫描模式可能会有助于厘清呼吸理疗对非合作人群的短期影响。
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Feasibility of high-frequency percussions in people with severe acquired brain injury and tracheostomy: an observational study.

People with severe acquired brain injury (pwSABI) frequently experience pulmonary complications. Among these, atelectasis can occur as a result of pneumonia, thus increasing the chance of developing acute respiratory failure. Respiratory physiotherapy contribution to the management of atelectasis in pwSABI is yet poorly understood. We conducted a retrospective analysis on 15 non-cooperative pwSABI with tracheostomy and spontaneously breathing, hospitalized and treated with high-frequency percussion physiotherapy between September 2018 and February 2021 at the Neurological Rehabilitation Unit of the IRCCS "S.Maria Nascente - Fondazione Don Gnocchi", Milan. Our primary aim was to investigate the feasibility of such a physiotherapy intervention method. Then, we assessed changes in respiratory measures (arterial blood gas analysis and peripheral night-time oxygen saturation) and high-resolution computed tomography lung images, evaluated before and after the physiotherapy treatment. The radiological measures were a modified radiological atelectasis score (mRAS) assigned by two radiologists, and an opacity score automatically provided by the software CT Pneumonia Analysis® that identifies the regions of abnormal lung patterns. Treatment diaries showed that all treatments were completed, and no adverse events during treatment were registered. Among the 15 pwSABI analyzed, 8 were treated with IPV® and 7 with MetaNeb®. After a median of 14 (I-III quartile=12.5-14.5) days of treatment, we observed a statistical improvement in various arterial blood gas measures and peripheral night-time oxygen saturation measures. We also found radiological improvement or stability in more than 80% of pwSABI. In conclusion, our physiotherapy approach was feasible, and we observed respiratory parameters and radiological improvements. Using technology to assess abnormal tomographic patterns could be of interest to disentangle the short-term effects of respiratory physiotherapy on non-collaborating people.

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CiteScore
3.60
自引率
0.00%
发文量
1
审稿时长
12 weeks
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