Zeiser E
Berufsförderungswerk Mainz, DIPLOMA Hochschule - Private Fachhochschule Nordhessen, z.H. Dorit Engelmann Lortzingstraße 4, 55127, Mainz, Deutschland.
Med Klin Intensivmed Notfmed. 2017 May;112(4):356-370. doi: 10.1007/s00063-016-0259-4. Epub 2017 Jan 23.
Guidelines cannot provide differentiated recommendations for physiotherapy (PT) in intensive care medicine. Scientific publications for PT in the intensive care unit (ICU) usually only have low levels of evidence and often express safety and feasibility of PT in the ICU.
Which measurement parameters are relevant for defining outcome and what interventions should one take into consideration?
A literature review was conducted. This was based on a PubMed search with full text access, as well as specific definitions for physical therapy, intensive care and four out of seven conditions from the manual "Physiotherapy in intensive care".
The availability of 172 studies clearly shows that there is certainly PT research concerning the critical environment of the ICU. However, parameters for quantitative and qualitative detection of vigilance and state of consciousness as well as assessments to evaluate the mobility and the ability to help themselves are important for everyday use.
The difficulties of using PT in the ICU are not useful in ensuring the safety of the patient or performing a PT treatment. The conditions of the intensive care environment are not an obstacle. It is of immanent importance to use the limited resources of PT in an optimal and targeted manner in the ICU environment. The determination of ICU-adapted goals plays a crucial role.
指南无法针对重症医学中的物理治疗(PT)提供差异化建议。关于重症监护病房(ICU)中PT的科学出版物通常证据水平较低,且常阐述PT在ICU中的安全性和可行性。
哪些测量参数与定义结局相关,应考虑哪些干预措施?
进行了一项文献综述。这基于对PubMed的全文检索,以及对物理治疗、重症监护和《重症监护中的物理治疗》手册中七种情况中的四种情况的具体定义。
172项研究的可得性清楚表明,确实存在关于ICU危急环境的PT研究。然而,用于定量和定性检测警觉性和意识状态的参数,以及评估活动能力和自理能力的评估方法,对日常使用很重要。
在ICU中使用PT的困难对确保患者安全或进行PT治疗并无帮助。重症监护环境的条件并非障碍。在ICU环境中以最佳和有针对性的方式利用有限的PT资源至关重要。确定适合ICU的目标起着关键作用。