School of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey.
Disabil Rehabil. 2010;32(17):1461-6. doi: 10.3109/09638280903531212.
To determine the haemodynamic effects of intensive care physiotherapy after liver transplantation.
Thirteen patients were included in the study after liver transplantation. The following physiotherapy programme were applied to the patients in intensive care unit: Respiratory physiotherapy, active joint movements, sitting in bed (first task), sitting at the edge of bed (second task), standing (third task), sitting out of bed (fourth task) and walking (fifth task). Heart rate (HR), mean, systolic and diastolic blood pressures (MBP, SBP, DBP), peripheral oxygen saturation (SpO(2)), respiration rate (RR) were recorded before treatment, after each task, after treatment and at the fifth minute of recovery. Pain level was assessed with Visual Analogue Scale (0-10).
When compared with supine position before treatment, all of the parameters except RR increased after the first task whereas HR, SBP, MBP and pain increased after the second task. After the third task only HR and pain increased. There was no significant difference between the fourth task and pre-treatment values while HR, DBP and pain increased after the fifth task. When measurements of pre-treatment, immediately after treatment and the fifth minute of recovery were compared HR, MBP and pain increased after treatment whereas HR, RR and pain decreased after recovery. There was no significant difference between pre-treatment values and fifth minute of recovery measurements.
Returning to initial values after a 5-min period shows that cardiopulmonary changes caused by intensive care physiotherapy after liver transplantation are responded at physiological limits.
确定肝移植后重症监护理疗的血液动力学效应。
肝移植后,13 例患者纳入研究。对重症监护病房的患者应用以下理疗方案:呼吸理疗、主动关节运动、卧床坐起(第一任务)、床边坐起(第二任务)、站立(第三任务)、床旁坐起(第四任务)和行走(第五任务)。在治疗前、每个任务后、治疗后和恢复的第 5 分钟记录心率(HR)、平均、收缩压和舒张压(MBP、SBP、DBP)、外周血氧饱和度(SpO2)、呼吸频率(RR)。疼痛程度采用视觉模拟评分法(0-10)评估。
与治疗前仰卧位相比,除 RR 外,所有参数在第一任务后均增加,而 HR、SBP、MBP 和疼痛在第二任务后增加。第三任务后仅 HR 和疼痛增加。第四任务与治疗前无显著差异,而第五任务后 HR、DBP 和疼痛增加。与治疗前、治疗后即刻和恢复第 5 分钟的测量值相比,治疗后 HR、MBP 和疼痛增加,而恢复后 HR、RR 和疼痛减少。治疗前与恢复第 5 分钟的测量值无显著差异。
5 分钟后恢复到初始值表明,肝移植后重症监护理疗引起的心肺变化在生理限度内得到了反应。