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不同早期康复技术对镇静患者血流动力学和代谢参数的影响:一项随机、单盲、交叉试验方案

Effects of different early rehabilitation techniques on haemodynamic and metabolic parameters in sedated patients: protocol for a randomised, single-bind, cross-over trial.

作者信息

Medrinal Clément, Combret Yann, Prieur Guillaume, Robledo Quesada Aurora, Bonnevie Tristan, Gravier Francis Edouard, Frenoy Éric, Contal Olivier, Lamia Bouchra

机构信息

Normandie Univ, UNIROUEN, EA3830-GRHV, Rouen, France; Institute for Research and Innovation in Biomedicine (IRIB), Rouen, France; Intensive Care Unit Department, Groupe Hospitalier du Havre, Montivilliers, France.

Physiotherapy Department , Groupe Hospitalier du Havre , Montivilliers , France.

出版信息

BMJ Open Respir Res. 2017 Jan 30;4(1):e000173. doi: 10.1136/bmjresp-2016-000173. eCollection 2017.

Abstract

INTRODUCTION

Early rehabilitation has become widespread practice for patients in intensive care; however, the prevalence of intensive care unit-acquired weakness remains high and the majority of physiotherapy is carried out in bed. Several inbed rehabilitation methods exist, but we hypothesise that techniques that provoke muscle contractions are more effective than passive techniques.

METHODS

A randomised, controlled cross-over study will be carried out to evaluate and compare the effectiveness of early rehabilitation techniques on cardiac output (CO) in sedated patients in intensive care. 20 intubated and sedated patients will undergo 4 10 min rehabilitation sessions. 2 sessions will involve 'passive' techniques based on mobilisations and inbed cycle ergometry and 2 involving electrostimulation of the quadriceps muscle and Functional Electrical Stimulation-cycling (FES-cycling). The primary outcome is CO measured by Doppler ultrasound. The secondary outcomes are right ventricular function, pulmonary systolic arterial pressure, muscle oxygenation and minute ventilation during exercise.

RESULTS AND CONCLUSION

Approval has been granted by our Institutional Review Board (Comité de Protection des Personnes Nord-Ouest 3). The results of the trial will be presented at national and international meetings and published in peer-reviewed journals.

TRIAL REGISTRATION NUMBER

NCT02920684.

摘要

引言

早期康复已成为重症监护患者的普遍治疗方法;然而,重症监护病房获得性肌无力的患病率仍然很高,并且大多数物理治疗是在床上进行的。存在几种床上康复方法,但我们推测引发肌肉收缩的技术比被动技术更有效。

方法

将进行一项随机对照交叉研究,以评估和比较早期康复技术对重症监护中镇静患者的心输出量(CO)的有效性。20名插管并镇静的患者将接受4次每次10分钟的康复治疗。2次治疗将采用基于活动和床上踏车运动的“被动”技术,另外2次治疗将采用股四头肌电刺激和功能性电刺激骑行(FES-骑行)。主要结局是通过多普勒超声测量的心输出量。次要结局是运动期间的右心室功能、肺动脉收缩压、肌肉氧合和分钟通气量。

结果与结论

我们的机构审查委员会(西北保护人类委员会3)已批准该研究。试验结果将在国内和国际会议上公布,并发表在同行评审期刊上。

试验注册号

NCT02920684。

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