全身振动预防重症监护病房获得性肌无力：安全性、可行性及代谢反应
Whole-body vibration to prevent intensive care unit-acquired weakness: safety, feasibility, and metabolic response.
作者信息
Wollersheim Tobias, Haas Kurt, Wolf Stefan, Mai Knut, Spies Claudia, Steinhagen-Thiessen Elisabeth, Wernecke Klaus-D, Spranger Joachim, Weber-Carstens Steffen
机构信息
Department of Anesthesiology and Operative Intensive Care Medicine, Campus Virchow Klinikum and Campus Mitte, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin, 13353, Germany.
Berlin Institute of Health (BIH), Berlin, 13353, Germany.
出版信息
Crit Care. 2017 Jan 9;21(1):9. doi: 10.1186/s13054-016-1576-y.
BACKGROUND
Intensive care unit (ICU)-acquired weakness in critically ill patients is a common and significant complication affecting the course of critical illness. Whole-body vibration is known to be effective muscle training and may be an option in diminishing weakness and muscle wasting. Especially, patients who are immobilized and not available for active physiotherapy may benefit. Until now whole-body vibration was not investigated in mechanically ventilated ICU patients. We investigated the safety, feasibility, and metabolic response of whole-body vibration in critically ill patients.
METHODS
We investigated 19 mechanically ventilated, immobilized ICU patients. Passive range of motion was performed prior to whole-body vibration therapy held in the supine position for 15 minutes. Continuous monitoring of vital signs, hemodynamics, and energy metabolism, as well as intermittent blood sampling, took place from the start of baseline measurements up to 1 hour post intervention. We performed comparative longitudinal analysis of the phases before, during, and after intervention.
RESULTS
Vital signs and hemodynamic parameters remained stable with only minor changes resulting from the intervention. No application had to be interrupted. We did not observe any adverse event. Whole-body vibration did not significantly and/or clinically change vital signs and hemodynamics. A significant increase in energy expenditure during whole-body vibration could be observed.
CONCLUSIONS
In our study the application of whole-body vibration was safe and feasible. The technique leads to increased energy expenditure. This may offer the chance to treat patients in the ICU with whole-body vibration. Further investigations should focus on the efficacy of whole-body vibration in the prevention of ICU-acquired weakness.
TRIAL REGISTRATION
Applicability and Safety of Vibration Therapy in Intensive Care Unit (ICU) Patients. ClinicalTrials.gov NCT01286610 . Registered 28 January 2011.
背景
重症监护病房（ICU）获得性肌无力是危重症患者常见且严重的并发症，会影响危重症病程。全身振动已知是有效的肌肉训练方法，可能是减轻肌无力和肌肉萎缩的一种选择。特别是对于那些固定不动且无法进行主动物理治疗的患者可能有益。到目前为止，尚未对机械通气的ICU患者进行全身振动研究。我们研究了危重症患者全身振动的安全性、可行性及代谢反应。
方法
我们研究了19例机械通气、固定不动的ICU患者。在仰卧位进行15分钟全身振动治疗前，先进行被动活动范围检查。从基线测量开始直至干预后1小时，持续监测生命体征、血流动力学和能量代谢，并进行间歇性血样采集。我们对干预前、干预期间和干预后的阶段进行了比较纵向分析。
结果
生命体征和血流动力学参数保持稳定，干预仅导致轻微变化。无需中断任何操作。我们未观察到任何不良事件。全身振动未显著和/或临床上改变生命体征和血流动力学。可观察到全身振动期间能量消耗显著增加。
结论
在我们的研究中，全身振动的应用是安全可行的。该技术导致能量消耗增加。这可能为在ICU中对患者进行全身振动治疗提供机会。进一步的研究应关注全身振动在预防ICU获得性肌无力方面的疗效。
试验注册
重症监护病房（ICU）患者振动治疗的适用性和安全性。ClinicalTrials.gov NCT01286610。2011年1月28日注册。
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