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重症监护病房早期活动的有效性、安全性及障碍

Effectiveness, Safety, and Barriers to Early Mobilization in the Intensive Care Unit.

作者信息

Alaparthi Gopala Krishna, Gatty Aishwarya, Samuel Stephen Rajan, Amaravadi Sampath Kumar

机构信息

Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, UAE.

Department of Physiotherapy, Kastruba Medical College Mangalore, Manipal Academy of Higher Education, Mangaluru, Karnataka, India.

出版信息

Crit Care Res Pract. 2020 Nov 26;2020:7840743. doi: 10.1155/2020/7840743. eCollection 2020.

Abstract

PURPOSE

Patients admitted to the intensive care unit (ICU) are generally confined to bed leading to limited mobility that may have detrimental effects on different body systems. Early mobilization prevents or reduces these effects and improves outcomes in patients following critical illness. The purpose of this review is to summarize different aspects of early mobilization in intensive care.

METHODS

Electronic databases of PubMed, Google Scholar, ScienceDirect, and Scopus were searched using a combination of keywords. Full-text articles meeting the inclusion criteria were selected.

RESULTS

Fifty-six studies on various aspects such as the effectiveness of early mobilization in various intensive care units, newer techniques in early mobilization, outcome measures for physical function in the intensive care unit, safety, and practice and barriers to early mobilization were included. Early mobilization is found to have positive effects on various outcomes in patients with or without mechanical ventilation. The newer techniques can be used to facilitate early mobilization. Scoring systems-specific to the ICU-are available and should be used to quantify patients' status at different intervals of time. Early mobilization is not commonly practiced in many countries. Various barriers to early mobilization have been identified, and different strategies can be used to overcome them.

摘要

目的

入住重症监护病房(ICU)的患者通常需卧床,导致活动受限,这可能会对不同身体系统产生不利影响。早期活动可预防或减轻这些影响,并改善危重症患者的预后。本综述的目的是总结重症监护中早期活动的不同方面。

方法

使用关键词组合检索PubMed、谷歌学术、ScienceDirect和Scopus等电子数据库。选择符合纳入标准的全文文章。

结果

纳入了56项关于早期活动在各个重症监护病房的有效性、早期活动的新技术、重症监护病房身体功能的结局指标、安全性以及早期活动的实践与障碍等各个方面的研究。结果发现,早期活动对接受或未接受机械通气的患者的各种结局均有积极影响。可使用新技术来促进早期活动。有专门针对ICU的评分系统,应使用这些系统来量化患者在不同时间间隔的状态。早期活动在许多国家并不普遍。已确定了早期活动的各种障碍,可采用不同策略来克服这些障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b57f/7714600/e85aa9dec6be/CCRP2020-7840743.001.jpg

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