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烧伤患者在重症监护中的搬运实践。

Mobilization practices for patients with burn injury in critical care.

机构信息

Department of Physiotherapy, Communication Science and Disorders, Occupational Therapy, University of São Paulo, Rua Cipotânea, 51, Cidade Universitária - CEP 05360-000, São Paulo, SP, Brazil.

Burn ICU, Hospital das Clínicas da Faculdade de Medicina, University of São Paulo, Rua Dr. Ovídio Pires de Campos, 225 - Cerqueira César - CEP 05403-010, São Paulo, SP, Brazil.

出版信息

Burns. 2020 Mar;46(2):314-321. doi: 10.1016/j.burns.2019.07.037. Epub 2019 Aug 26.

Abstract

PURPOSE

Patients with burn usually undergo prolonged hospitalization due partially to the treatment of wounds and scars. Although the benefits of early mobilization are well-known in critical care patients, there are a lack of studies reporting mobilization practices and functional status for patients with burn.

MATERIALS

Clinical and physiotherapy data were daily collected, including ICU mobility scale (IMS) and reported barriers to mobilization therapy during a one-year period. At hospital discharge, the 6-min walking test (6MWT), Medical Research Council scale (MRCS) and handgrip strength test were applied to evaluate the patients' functionality.

RESULTS

Of the 74 patients admitted, 66% were placed on mechanical ventilation (MV). Mobilization therapy was administered in 67.2% of physiotherapy sessions, with passive mobilization being the most prevalent (53.2%) followed by active in-bed exercises (13.6%). Reported barriers for mobilization included hemodynamic instability followed by limited time for assistance. At hospital discharge, the 6MWD was 270(136) meters. A positive correlation was found between handgrip evaluation and 6MWD and a negative correlation with hospital length of stay.

CONCLUSIONS

Mobilization therapy of patients with burns in the ICU was characterized by a low mobility level during MV with a low functional status at hospital discharge.

摘要

目的

烧伤患者通常需要长时间住院治疗,部分原因是伤口和疤痕的治疗。尽管早期活动对重症监护患者的益处众所周知,但缺乏关于烧伤患者活动实践和功能状态的研究。

材料

在一年的时间里,每天收集临床和物理治疗数据,包括重症监护室活动量表(IMS)和报告的活动治疗障碍。在出院时,应用 6 分钟步行测试(6MWT)、医学研究委员会量表(MRCS)和握力测试评估患者的功能。

结果

在 74 名入院患者中,66%的患者需要机械通气(MV)。在 67.2%的物理治疗中进行了活动治疗,被动活动最为常见(53.2%),其次是主动床上运动(13.6%)。活动障碍的报告包括血流动力学不稳定,其次是辅助时间有限。出院时,6MWD 为 270(136)米。握力评估与 6MWD 呈正相关,与住院时间呈负相关。

结论

在 MV 期间,烧伤患者在 ICU 的活动治疗以低活动水平为特征,出院时的功能状态较低。

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