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机械通气患者早期职业治疗可改善功能状态:研究方案。

Early occupational therapy in mechanically ventilated patients improves functional status: Study protocol.

作者信息

Álvarez Evelyn, Garrido Maricel, Salech Felipe, Rojas Verónica, Jara Nicole, Farías José I, Ponce Daniela, Tobar Eduardo

机构信息

Departamento de Terapia Ocupacional y Ciencia de la Ocupación, Facultad de Medicina, Universidad de Chile, Santiago, Chile.

Centro de Estudios en Neurociencia Humana y Neuropsicología, Facultad de Psicología, Universidad Diego Portales, Santiago, Chile.

出版信息

Br J Occup Ther. 2023 Nov;86(11):728-739. doi: 10.1177/03080226231184992. Epub 2023 Jul 14.

Abstract

BACKGROUND

Experts suggest implementing measures that include analgesia, sedation, delirium prevention and early mobilization (ASDM) in patients undergoing mechanical ventilation (MV) to reduce complications. However, there is limited evidence of occupational therapy in these patients. The aim of the research is to compare functional independence in patients undergoing MV of an intensive and early occupational therapy protocol versus to standard ASDM strategy.

METHOD/DESIGN: A prospective, multicenter, randomized clinical trial, with parallel groups (control and intervention groups). Participants will be hospitalized patients, over 18 years of age, admitted to the intensive care unit (ICU) and with the need of invasive MV. The intervention group will receive two daily 30-minute sessions of occupational therapy for 10 days. This study will research the effect of occupational therapy on functional independence, motor and cognitive status, evaluating at days 28 and 90.

DISCUSSION

This work contributes to the theoretical and practical work of occupational therapists who work in the ICU. The implementation of protocols of occupational therapy in mechanically ventilated patients can contribute to the independence and functionality of patients.

CONCLUSION

Our research aims to contribute to the generation of systematized, organized, and feasible protocols that can be implemented in ICU.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04819529.

摘要

背景

专家建议对接受机械通气(MV)的患者采取包括镇痛、镇静、预防谵妄和早期活动(ASDM)在内的措施,以减少并发症。然而,关于这些患者接受职业治疗的证据有限。本研究的目的是比较强化早期职业治疗方案与标准ASDM策略在接受MV患者中的功能独立性。

方法/设计:一项前瞻性、多中心、随机临床试验,采用平行组(对照组和干预组)。参与者将为18岁以上入住重症监护病房(ICU)且需要有创MV的住院患者。干预组将接受为期10天、每天两次、每次30分钟的职业治疗。本研究将在第28天和第90天评估职业治疗对功能独立性、运动和认知状态的影响。

讨论

这项工作有助于在ICU工作的职业治疗师的理论和实践工作。对机械通气患者实施职业治疗方案有助于提高患者的独立性和功能。

结论

我们的研究旨在促进生成可在ICU实施的系统化、有组织且可行的方案。

试验注册

ClinicalTrials.gov NCT04819529。

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