物理疗法对重症监护病房患者功能状态和住院时间的影响

IF 0.2 Q4 RESPIRATORY SYSTEM Current Respiratory Medicine Reviews Pub Date : 2022-08-18 DOI:10.2174/1573398x18666220818095151
Amrutha Hosakote Mahesh, Renukadevi Mahadevan, C. Krishnarao
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引用次数: 0

摘要

危重疾病患者的早期动员可减少长时间卧床休息的后果,并改善自我保健功能和生活质量。任何ICU机械通气患者的早期活动都可以防止患者出现螺旋式的进行性并发症,从而导致养老院安置或持续的危重疾病。ICU患者的早期活动可改善肌力和功能独立性,缩短谵妄持续时间、机械通气和ICU住院时间。本研究旨在评估物理治疗管理和早期活动对入住重症监护病房的患者功能状态和住院时间的影响。在印度南部迈索尔的一家三级保健大学教学医院,对内科和外科重症监护病房收治的患者进行了一项观察性研究。对患者进行评估,并记录患者的基线特征。研究对象被分为两组,干预组和对照组。干预组71例,对照组67例。干预组接受物理治疗管理和早期活动。对照组未进行物理治疗管理和早期活动。给予物理治疗干预2-3次/天,观察结果为ICU住院时间和使用Chelsea重症监护物理评估工具(CPAx)评估物理发病率。结果显示,干预组患者的呼吸机支持(3.86±3.4和5.59±4.3,p = 0.005)和氧气支持(5.23±0.99和7.48±2.0,p =0.000)断奶时间明显早于对照组。干预组患者在ICU的住院时间(7.71±3.70 d)明显少于对照组(11.64±4.8 d, p = 0.000)。分别。本研究表明,与未进行物理治疗干预和早期动员的患者相比,在重症监护病房接受治疗的危重患者实施物理治疗干预和早期动员可使其早日脱离呼吸机支持和补充氧治疗,并改善功能状态,从而缩短ICU住院时间。
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Impact of Physiotherapy on Functional Status and Length of Stay of Patients Admitted to Intensive Care Unit
Early mobilization of patients with critical illness reduces the consequences of extended periods of bed rest and improves self-care functions and quality of life. Early mobilization for mechanically ventilated patients in any ICU prevents patients from a spiral of progressive complications, leading to either nursing home placement or persistent critical illness. Early mobilization of ICU patients has been associated with improved muscle strength and functional independence, a shorter duration of delirium, mechanical ventilation, and ICU length of stay. This study was undertaken to assess the impact of physiotherapy management and early mobilization on Functional Status and Length of Stay in patients admitted to the Intensive Care Unit. An observational study was conducted at a tertiary care university teaching hospital in Mysore, South India, among patients admitted to medical and surgical intensive care units. The patients were assessed, and the patient’s baseline characteristics were recorded. The study subjects were divided into two groups, the intervention and the control groups. There were 71 patients in the intervention group and 67 patients control group. Subjects in the intervention group underwent physiotherapy management and early mobilization. Subjects in the control group did not undergo physiotherapy management and early mobilization. Physiotherapy intervention was given 2-3 times/day, and the outcome measures were the length of stay in ICU and assessment of physical morbidity using the Chelsea Critical Care Physical Assessment Tool (CPAx). The results showed that subjects in the intervention group were weaned from the ventilator support (3.86±3.4 and 5.59 ±4.3, p = 0.005) and oxygen support (5.23±0.99 and 7.48±2.0, p = 0.000) much earlier than the subjects in the control group. The length of ICU stay was significantly less in the intervention group than in the control group (7.71±3.70 days and 11.64±4.8 days with a p-value, p = 0.000). respectively. This study demonstrated that implementation of physiotherapy intervention and early mobilization in critically ill patients undergoing treatment in intensive care unit resulted in early weaning from ventilator support and supplemental oxygen therapy, with improvement in functional status leading to reduced length of ICU stays compared to the patients who were not given physiotherapy intervention and early mobilization.
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期刊介绍: Current Respiratory Medicine Reviews publishes frontier reviews on all the latest advances on respiratory diseases and its related areas e.g. pharmacology, pathogenesis, clinical care, and therapy. The journal"s aim is to publish the highest quality review articles dedicated to clinical research in the field. The journal is essential reading for all researchers and clinicians in respiratory medicine.
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