González-Seguel Felipe, Cáceres-Parra Camilo
Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile.
Rev Med Chil. 2022 Dec;150(12):1565-1574. doi: 10.4067/s0034-98872022001201565.
Physical functioning evaluation in intensive care units (ICUs) identifies rehabilitation requirements and response to interventions.
To identify the usage rate of physical functioning measurement instruments in ICUs during the COVID-19 pandemic in Chile.
Lead physiotherapists representing different national ICUs were invited to answer a National online survey at the onset (T1) and at the first year of COVID-19 pandemic (T2). The usage rate (defined as "always"/"almost always"/"almost never"/"never") of instruments assessing muscle strength, muscle mass, mobility, and physical performance was surveyed. Also, the reasons for selecting these instruments were requested.
We received responses from 94 and 93 ICUs at T1 and T2, respectively, of 111 eligible ICUs (55% public). Compared with T2, the usage rate of instruments was lower at T1, and significant only for Medical Research Sum-Score (MRC-SS) (p = 0.04) and handgrip dynamometry (p = 0.05). Considering the answers "always", "almost always" and "almost never", between 89% and 91% of the ICUs reported the use of the MRC-SS; between 70% and 73% reported the use of the Functional Status Score for the Intensive Care Unit; between 5% and 35% of the ICUs reported the use of the rest of mobility scales; and between 44%-45% of ICUs reported that muscle ultrasound was "almost never" used. The main reasons reported for selecting instruments were quick use and clinimetric properties.
The usage rate of muscle strength assessments was frequent, while the use of mobility and muscle mass instruments recommended by the literature was poorly reported, which was lower at the onset of the pandemic.
重症监护病房(ICU)中的身体功能评估可确定康复需求及对干预措施的反应。
确定智利新冠疫情期间ICU中身体功能测量工具的使用率。
邀请代表不同国家ICU的首席物理治疗师在新冠疫情开始时(T1)和疫情第一年(T2)回答一项全国在线调查。调查了评估肌肉力量、肌肉质量、活动能力和身体表现的工具的使用率(定义为“总是”/“几乎总是”/“几乎从不”/“从不”)。此外,还询问了选择这些工具的原因。
在111个符合条件的ICU(55%为公立)中,我们分别收到了来自94个和93个ICU在T1和T2的回复。与T2相比,T1时工具的使用率较低,仅医学研究总和评分(MRC-SS)(p = 0.04)和握力测量法(p = 0.05)有显著差异。考虑“总是”、“几乎总是”和“几乎从不”的回答,89%至91%的ICU报告使用了MRC-SS;70%至73%的ICU报告使用了重症监护病房功能状态评分;5%至35%的ICU报告使用了其他活动能力量表;44% - 45%的ICU报告肌肉超声“几乎从不”使用。报告选择工具的主要原因是使用快捷和临床测量特性。
肌肉力量评估的使用率较高,而文献推荐的活动能力和肌肉质量测量工具的使用情况报告较少,在疫情开始时更低。