Hashem Mohamed D, Nelliot Archana, Needham Dale M
Outcomes after Critical Illness and Surgery Group and the Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
Outcomes after Critical Illness and Surgery Group and the Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland. Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
Respir Care. 2016 Jul;61(7):971-9. doi: 10.4187/respcare.04741. Epub 2016 Apr 19.
Despite the historical precedent of mobilizing critically ill patients, bed rest is common practice in ICUs worldwide, especially for mechanically ventilated patients. ICU-acquired weakness is an increasingly recognized problem, with sequelae that may last for months and years following ICU discharge. The combination of critical illness and bed rest results in substantial muscle wasting during an ICU stay. When initiated shortly after the start of mechanical ventilation, mobilization and rehabilitation can play an important role in decreasing the duration of mechanical ventilation and hospital stay and improving patients' return to functional independence. This review summarizes recent evidence supporting the safety, feasibility, and benefits of early mobilization and rehabilitation of mechanically ventilated patients and presents a brief summary of future directions for this field.
尽管有动员重症患者的历史先例，但卧床休息仍是全球重症监护病房的常见做法，尤其是对于机械通气患者。重症监护病房获得性肌无力是一个日益受到认可的问题，其后遗症可能在重症监护病房出院后持续数月甚至数年。重症疾病和卧床休息相结合会导致在重症监护病房住院期间出现大量肌肉萎缩。在机械通气开始后不久启动活动和康复，可在缩短机械通气时间和住院时间以及改善患者恢复功能独立方面发挥重要作用。本综述总结了近期支持机械通气患者早期活动和康复的安全性、可行性及益处的证据，并简要概述了该领域的未来发展方向。
