[蛛网膜下腔出血患者在重症监护病房的早期活动——综述]
[Early mobilization in the intensive care unit for patients with subarachnoid hemorrhage-a review].
作者信息
Widmaier Jacqueline, Schindele Denise, Lichtinger Karin
机构信息
RKH Gesundheit Klinikum Ludwigsburg, Zentrum für interdisziplinäre Intensivmedizin, Deutschland, Posilipostraße 4, 71640, Ludwigsburg.
Paracelsus Medizinische Privatuniversität, Institut für Pflegewissenschaft und -praxis, Salzburg, Österreich.
出版信息
Med Klin Intensivmed Notfmed. 2025 May;120(4):340-347. doi: 10.1007/s00063-024-01231-y. Epub 2025 Jan 12.
BACKGROUND
Early mobilization of critical ill patients in the intensive care unit (ICU) has a positive effect on outcome. Currently, due to concerns of cerebral vasospasm and rebleeding patients with subarachnoid hemorrhage (SAH) have a prolong bedrest for 12-14 days.
OBJECTIVE
What effect does early mobilization have on vasospasm, clinical outcome, length of stay and ICU complication rate in patients with SAH compared to standard treatment?
METHODS
A systematic literature search was conducted in MEDLINE via the PubMed® (U.S. National Library of Medicine®, Bethesda, MD, USA) and CINAHL® (EBSCO, Ipswich, MA, USA) databases.
RESULTS
A total of 14 studies were identified. Overall, the studies showed an improved functional outcome and a reduction in the length of hospitalization and ventilation time. Only in one study did vasospasms occur more frequently and the outcome of patients with early mobilization was worse.
CONCLUSION
Further research is needed to identify possible positive effects of early mobilization in patients with SAH and to be able to describe the risk-benefit ratio more precisely.
背景
重症监护病房（ICU）中危重症患者的早期活动对预后有积极影响。目前，由于担心蛛网膜下腔出血（SAH）患者发生脑血管痉挛和再出血，其需卧床休息12 - 14天。
目的
与标准治疗相比，早期活动对SAH患者的血管痉挛、临床结局、住院时间和ICU并发症发生率有何影响？
方法
通过美国国立医学图书馆（位于美国马里兰州贝塞斯达）的PubMed®检索MEDLINE数据库，并通过美国马萨诸塞州伊普斯威奇的EBSCO检索CINAHL®数据库，进行系统的文献检索。
结果
共识别出14项研究。总体而言，这些研究表明功能结局得到改善，住院时间和通气时间缩短。只有一项研究中，血管痉挛更频繁发生，早期活动患者的结局更差。
结论
需要进一步研究以确定早期活动对SAH患者可能的积极影响，并更精确地描述风险效益比。
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