Application of the respiratory “critical care-sub-critical care-rehabilitation integrated management model” in severe stroke associated pneumonia

Abstract

Background: This study aimed to explore the feasibility of applying the respiratory "critical care-sub-critical carerehabilitation integrated management model" in severe stroke-associated pneumonia and evaluate its effect. Methods: From January to September 2018, 24 patients with severe stroke-associated pneumonia, who were admitted to the Respiratory Intensive Care Unit of the Respiratory and Critical Care Medicine Department of Henan Provincial People's Hospital, were randomly divided into two groups: integrated management group and control group. According to the admission criteria of the respiratory "critical care-sub-critical care-rehabilitation integrated model" prescribed by the above-mentioned hospital, patients were grouped. The professional respiratory therapy team participated in the whole treatment. The acute physiology and chronic health evaluation II (APACHE II) score, clinical pulmonary infection score (CPIS) and oxygenation index of these two groups were dynamically observed, and the average hospital stay, 28-day mortality and patient satisfaction were investigated. Results: Patients in the integrated management group and control group were similar before treatment (P > 0.05). After treatment, the main indicators, the APACHE II score, CPIS score and oxygenation index, were significantly different between the integration group and control group (P < 0.05). The secondary indicators, the average hospitalization days and patient/family member satisfaction scores, were also significantly different between the integration group and control group (P < 0.05). However, the 28-day mortality wasn't significantly different (P > 0.05). Conclusions: For patients with severe stroke-associated pneumonia, it was feasible to implement the respiratory "critical care-sub-critical care-rehabilitation integrated management model", which could significantly improve the treatment effect, shorten average hospitalization days and improve patient/family satisfaction.

The effectiveness and safety of centralized early rehabilitation care for critically ill children with severe acquired brain injury: A retrospective cohort and implementation study

“…For adult patients with severe stroke associated pneumonia, the respiratory “critical care-sub-critical care-rehabilitation integrated management model” could significantly improve the treatment effect by measuring clinical pulmonary infection score (CPIS), oxygenation index and the acute physiology and chronic health evaluation II (APACHE II) score at discharge, shorten average hospitalization days and improve patient/family satisfaction. 21 …”

“…For adult patients with severe stroke associated pneumonia, the respiratory "critical care-sub-critical care-rehabilitation integrated management model" could significantly improve the treatment effect by measuring clinical pulmonary infection score (CPIS), oxygenation index and the acute physiology and chronic health evaluation II (APACHE II) score at discharge, shorten average hospitalization days and improve patient/family satisfaction. 21 In addition, there is also research evidence that the monitoring and rehabilitation interventions of dysphagia can also prevent pneumonia in sABI patients. Dysphagia is a common and critical consequence of sABI, which can lead to the tracheobronchial aspiration that may cause pneumonia.…”

Global approaches for global challenges: The possible support of rehabilitation in the management of COVID‐19

“…4 respiratory diseases could not be enough for patient's recovery. 5 The rehabilitation approach can be independent of the setting: hospital, intensive care unit (ICU), and home. 6 To evaluate the impact of rehabilitation in the severe coronavirus diseases, we have started from the analysis by Li et al, 1 who considered SARS-CoV and MERS-CoV.…”