Department of Healthcare Professions, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Anesthesia, Intensive Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Department of Healthcare Professions, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Intensive Crit Care Nurs. 2022 Apr;69:103160. doi: 10.1016/j.iccn.2021.103160. Epub 2021 Oct 28.
To evaluate the muscle strength and functional level of patients discharged from intensive care unit (ICU) in relation to the swimmer position as a nurse intervention during pronation.
Prospective study conducted in the hub COVID-19 center in Milan (Italy), between March and June 2020. All patients with COVID-19 discharged alive from ICU who received invasive mechanical ventilation were included. Forward continuation ratio model was fitted to explore the statistical association between muscle strength grades and body positioning during ICU stay.
Over the 128 patients admitted to ICU, 87 patients were discharged alive from ICU, with available follow-up measures at hospital discharge. Thirty-four patients (39.1%) were treated with prone positioning as rescue therapy, for a total of 106 pronation cycles with a median duration of 72 (IQR 60-83) hours. Prone positioning did not influence the odds of showing particular level of muscle strength, in any of the evaluated districts, namely shoulder (OR 1.34, 95%CI:0.61-2.97), elbow (OR 1.10, 95%CI:0.45-2.68) and wrist (OR 0.97, 95%CI:0.58-1.63). Only in the shoulder district, age showed evidence of association with strength (OR 1.06, 95%CI:1.02-1.10), affecting people as they get older. No significant sequalae related to swimmer position were reported by physiotherapists or nurses.
Swimmer position adopted during prone ventilation is not associated with worse upper limb strength or poor mobility level in COVID-19 survivors after hospital discharge.
评估重症监护病房（ICU）出院患者的肌肉力量和功能水平与作为护士干预的旋前位的关系。
这是一项在 2020 年 3 月至 6 月期间于意大利米兰 COVID-19 中心进行的前瞻性研究。纳入所有从 ICU 出院且存活的 COVID-19 患者，这些患者接受了有创机械通气。采用向前连续比模型来探索 ICU 期间肌肉力量等级与身体定位之间的统计学关联。
在入住 ICU 的 128 名患者中，有 87 名患者从 ICU 存活出院，并且在出院时可以进行随访。34 名患者（39.1%）接受了俯卧位作为抢救治疗，总共进行了 106 次俯卧位翻身，中位时间为 72 小时（IQR 60-83）。俯卧位定位并没有影响任何评估区域的肌肉力量的特定水平的几率，包括肩部（OR 1.34，95%CI：0.61-2.97）、肘部（OR 1.10，95%CI：0.45-2.68）和腕部（OR 0.97，95%CI：0.58-1.63）。只有在肩部区域，年龄与力量具有明显的相关性（OR 1.06，95%CI：1.02-1.10），这影响到随着年龄的增长的人们。物理治疗师或护士没有报告与游泳者体位相关的任何明显后遗症。
在 COVID-19 幸存者出院后，俯卧位通气期间采用的游泳者体位与上肢力量下降或活动能力差无关。
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