School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Australia (Ms Mackney and Drs Harrold, Jenkins, and Hill); School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, Australia (Ms Mackney); Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, Australia (Ms Mackney); Physiotherapy Department, Sir Charles Gairdner Hospital, Perth, Australia (Dr Jenkins); Institute for Respiratory Health, Sir Charles Gairdner Hospital, Perth, Australia (Drs Jenkins and Hill); and Department of Intensive Care, John Hunter Hospital, New Lambton Heights, Australia (Mr Havill).
J Cardiopulm Rehabil Prev. 2019 Jul;39(4):E16-E22. doi: 10.1097/HCR.0000000000000432.
This study compared exercise responses in individuals who had recently survived an admission to the intensive care unit for acute lung injury (ALI) with healthy controls.
Ten patients with ALI were recruited at 2 Australian hospitals. Six weeks after hospital discharge, participants completed lung function measures and a laboratory-based cardiopulmonary exercise test. Identical measures were collected in 21 healthy participants of similar age and gender distribution.
Compared with the healthy participants, the ALI participants were similar in age (51 ± 14 vs 50 ± 16 yr), with a lower peak oxygen uptake ((Equation is included in full-text article.)O2) (median [interquartile range], 31.80 [26.60-41.73] vs 17.80 [14.85-20.85] mL/kg/min; P < .01) and higher ventilatory equivalent for carbon dioxide ((Equation is included in full-text article.)E/(Equation is included in full-text article.)CO2) at anaerobic threshold (mean ± SD, 25.7 ± 2.5 vs 35.2 ± 4.1; P < .01). Analysis of individual ALI participant responses showed that 8 participants had a decreased peak (Equation is included in full-text article.)O2 and anaerobic threshold. All ALI participants were limited by leg fatigue. Abnormalities of pulmonary gas exchange were present in 7 participants. Evidence of cardiac ischemia was present in 2 participants.
Compared with healthy controls, ALI participants had reduced exercise capacity, mainly due to profound deconditioning. Exercise training to optimize aerobic capacity would appear to be a rehabilitation priority in this population.
本研究比较了近期因急性肺损伤（ALI）入住重症监护病房后存活的个体与健康对照者的运动反应。
在澳大利亚的 2 家医院招募了 10 名 ALI 患者。出院后 6 周，参与者完成了肺功能测量和基于实验室的心肺运动测试。在年龄和性别分布相似的 21 名健康参与者中收集了相同的测量值。
与健康参与者相比，ALI 患者的年龄相似（51 ± 14 岁比 50 ± 16 岁），峰值摄氧量（(Equation is included in full-text article.)O2）更低（中位数[四分位间距]，31.80 [26.60-41.73]比 17.80 [14.85-20.85] mL/kg/min；P <.01），而在无氧阈时二氧化碳通气当量（(Equation is included in full-text article.)E/(Equation is included in full-text article.)CO2）更高（均值 ± 标准差，25.7 ± 2.5 比 35.2 ± 4.1；P <.01）。对个体 ALI 参与者反应的分析表明，有 8 名参与者的峰值 (Equation is included in full-text article.)O2 和无氧阈降低。所有 ALI 参与者均因腿部疲劳而受限。7 名参与者存在肺气体交换异常。2 名参与者存在心肌缺血的证据。
与健康对照者相比，ALI 患者的运动能力降低，主要是由于严重的适应性下降。在该人群中，优化有氧能力的运动训练似乎是康复的首要任务。
