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    標題: Early Mobilization Reduces Duration of Mechanical Ventilation and Intensive Care Unit Stay in Patients With Acute Respiratory Failure
    作者: Lai, Chih-Cheng
    Chou, Willy
    Chan, Khee-Siang
    Cheng, Kuo-Chen
    Yuan, Kuo-Shu
    Chao, Chien-Ming
    Chen, Chin-Ming
    貢獻者: Chi Mei Med Ctr, Dept Intens Care Med
    Chia Nan Univ Pharm & Sci, Dept Recreat & Hlth Care Management
    Chi Mei Med Ctr, Dept Internal Med
    Chung Hwa Univ Med Technol, Dept Safety Hlth & Environm
    Chi Mei Med Ctr, Dept Med Res
    Natl Sun Yat Sen Univ, Dept Business Management
    關鍵字: Early mobilization
    Intensive care units
    Mechanical ventilation
    Rehabilitation
    日期: 2017-05
    上傳時間: 2018-11-30 15:49:35 (UTC+8)
    出版者: W B Saunders Co-Elsevier Inc
    摘要: Objective: To evaluate the effects of a quality improvement program to introduce early mobilization on the outcomes of patients with mechanical ventilation (MV) in the intensive care unit (ICU). Design: A retrospective observational study. Setting: Nineteen-bed ICU at a medical center. Participants: Adults patients with MV (N=153) admitted to a medical ICU. Interventions: A multidisciplinary team (critical care nurse, nursing assistant, respiratory therapist, physical therapist, patient's family) initiated the protocol within 72 hours of MV when patients become hemodynamically stable. We did early mobilization twice daily, 5d/wk during family visits (30min each time), and cooperated with family, if possible. Main Outcome Measures: MV duration, rate of successful weaning, and length of ICU and hospital stay. Results: We enrolled 63 patients in the before protocol group and 90 in the after protocol group. The 2 groups were well matched in age, sex, body height, body weight, body mass index, disease severity, cause of intubation, number of comorbidities, and most underlying diseases. After protocol group patients had shorter MV durations (4.7d vs 7.5d; P<.001) and ICU stays (6.9d vs 9.9d; P =.001) than did before protocol group patients. Early mobilization was negatively associated with the duration of MV (beta=-.269; P<.002; 95% confidence interval [CI], -4.767 to -1.072), and the risk of MV for >= 7 days was lower in patients who underwent early mobilization (odds ratio,.082; 95% CI,.021-.311). Conclusions: The introduction of early mobilization for patients with MV in the ICU shortened MV durations and ICU stays. A multidisciplinary team that includes the patient's family can work together to improve the patient's clinical outcomes. (C) 2016 by the American Congress of Rehabilitation Medicine
    關聯: Archives of Physical Medicine and Rehabilitation, v.98, n.5, pp.931-939
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