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双心室辅助装置患者在重症监护病房的物理治疗

Physical therapy in the intensive care unit in a patient with biventricular assist device.

作者信息

Senduran Meric, Malkoc Mehtap, Oto Oztekin

机构信息

School of Physical Therapy and Rehabilitation, Dokuz Eylul University, Inciralt̅/IZMIR, TR-35330, Turkey.

出版信息

Cardiopulm Phys Ther J. 2011 Sep;22(3):31-4.

Abstract

PURPOSE

To determine the safety and feasibility of early physical therapy in the intensive care unit in a patient with biventricular assist device.

METHODS

Physical therapy started on the first postoperative day and continued till discharge including airway clearance, lower/upper extremity exercises, and mobilization. Heart rate (HR), respiratory rate (RR), systolic/diastolic/mean arterial pressures, peripheral oxygen saturation, and double product were recorded before treatment, after treatment, and 5 minutes after treatment.

RESULTS

In total, 15 sessions of physical therapy were implemented for a 41-year-old male patient during 21 days following implantation of a biventricular assist device. Normal physiological responses were seen in response to treatment. Heart rate increased significantly after treatment in comparison to pretreatment values (p = 0.02) and decreased significantly after 5 minutes (p = 0.03) and approached pretreatment values. Respiratory rate increased nonsignificantly after treatment and decreased significantly after 5 minutes (p = 0.001) and approached pretreatment values.

CONCLUSION

Physical therapy in the intensive care unit in a patient with biventricular assist device resulted in significant increases within HR and RR in physiological limits. Ongoing monitoring of vital signs is recommended in order to observe physiological responses to early physical therapeutic interventions in the intensive care unit.

摘要

目的

确定在植入双心室辅助装置的患者中,重症监护病房早期物理治疗的安全性和可行性。

方法

物理治疗于术后第一天开始,持续至出院,包括气道清理、下肢/上肢运动及活动。在治疗前、治疗后及治疗后5分钟记录心率(HR)、呼吸频率(RR)、收缩压/舒张压/平均动脉压、外周血氧饱和度及双乘积。

结果

在植入双心室辅助装置后的21天内,共对一名41岁男性患者实施了15次物理治疗。治疗后出现正常的生理反应。与治疗前相比,治疗后心率显著升高(p = 0.02),5分钟后显著下降(p = 0.03),并接近治疗前值。治疗后呼吸频率无显著升高,5分钟后显著下降(p = 0.001),并接近治疗前值。

结论

在植入双心室辅助装置的患者的重症监护病房中进行物理治疗,可使心率和呼吸频率在生理限度内显著升高。建议持续监测生命体征,以观察重症监护病房中早期物理治疗干预的生理反应。

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