国际成人重症监护室患者心肺物理治疗管理及新冠肺炎影响调查

G. Ntoumenopoulos, S. Patman
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摘要

本研究的目的是报告物理治疗师对危重患者使用的心肺评估、干预措施和结果测量以及COVID-19的影响。一项匿名的国际在线调查(通过谷歌表格)进行了物理治疗师的实践。这项研究是在成人重症监护病房进行的。共有309名理疗师参与了这项研究。一项调查是用来确定目前在ICU心肺物理治疗的做法。主要参与者为女性(74%),年龄31至40岁(40%),在重症监护病房(ICU)工作0至5年(38%)或11至20年(28%),全职工作(72%)。大多数参与者在英国(36%)、欧洲(21%)或澳大利亚/大洋洲(18%)工作。心肺物理治疗干预的3个最常报告的评估指标是肺叶塌陷/肺不张、可听分泌物和肺听诊音减少/增加。3种最常用的预后指标包括肺听诊、动脉血气分析和经皮动脉饱和度。3种最常用的物理治疗干预措施(“经常”按降序排列)包括患者活动、重新定位以优化气体交换和气管内吸引。在COVID-19队列中,参与者报告了类似的患者重新定位以优化气体交换和体位引流,减少了患者动员和气管内吸痰、深呼吸练习、主动循环呼吸技术和口咽吸痰的使用。本调查报告了在ICU工作的物理治疗师的特征,以及他们最常用的心肺物理治疗评估、干预措施和结果测量,包括COVID-19患者。与非COVID-19队列相比,向COVID-19队列提供的干预措施存在一些差异。
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International Survey of Cardiopulmonary Physical Therapy Management of Adult Intensive Care Unit Patients and the Impact of COVID-19
The aim of this study was to report on the cardiorespiratory assessments, interventions, and outcome measures used by physical therapists with critically ill patients and the impact of COVID-19. An anonymous international online survey of practice (through Google Forms) of physical therapists was conducted. The study was conducted in adult intensive care units. A total of 309 physical therapists participated in the study. A survey was used to determine current cardiopulmonary physical therapy practices in ICU. Predominantly participants were female (74%), aged 31 to 40 years (40%), having worked in intensive care unit (ICU) for either 0 to 5 years (38%) or 11 to 20 years (28%), and worked full time (72%). Most participants worked in the United Kingdom (36%), Europe (21%), or Australia/Oceania (18%). The 3 most frequently reported assessment indicators for cardiopulmonary physical therapy interventions were lobar collapse/atelectasis, audible secretions, and decreased/added lung auscultation sounds. The 3 most commonly used outcome measures included lung auscultation, arterial blood gas analysis, and transcutaneous arterial saturation. The 3 most commonly used physical therapy interventions (“very often” in a descending order) included patient mobilization, repositioning to optimize gas exchange, and endotracheal suctioning. For the COVID-19 cohort, participants reported similar use of patient repositioning to optimize gas exchange and postural drainage, and lower use of patient mobilization and endotracheal suctioning, deep breathing exercises, active cycle of breathing technique, and oropharyngeal suctioning. This survey reports on the characteristics of physical therapists who work in ICU, and their cardiopulmonary physical therapy assessments, interventions, and outcome measures most commonly used, inclusive of patients with COVID-19. There were some differences in interventions provided to the COVID-19 cohort compared with the non–COVID-19 cohort.
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