Outcome of Physical Therapy Intervention on Ventilator Weaning and Functional Status

Yang, Pei-Hsuan; Wang, Chuansheng; Wang, Yen-Ching; Yang, Chih-Jen; Hwang, Jhi-Jhu; Wang, Tung-Heng; Chuang, I-Chun; Huang, Ming-Shyan

doi:10.1016/s1607-551x(10)70060-7

Cited by 16 publications

(29 citation statements)

References 8 publications

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“…The results of Yang et al ,2010 [24] matches with the present study which sowed a non significant differences between both groups as regards the rate of successful weaning that was lower in that reported by Yang et al, as their study did not include threshold inspiratory training. They used traditional abdominal training and inspiratory muscle weight training combined with mobilization training.…”

Section: Comparison Between Group a And Group B Post Trainingsupporting

confidence: 87%

Comprehensive Rehabilitation Program Versus Traditional Chest Physiotherapy for Weaning from Mechanical Ventilator ; randomized clinical trial

ELmoutaz¹,

Rahmy²,

Eldin³

et al. 2020

Preprint

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Background Patients needing prolonged mechanical ventilation have poor outcomes and are increasing in number. Weakness of inspiratory muscles is a well- established complication of prolonged mechanical ventilator , however the role of physical therapist has been expanded towards rehabilitation rather than inspiratory care only. The purpose of this study was to compare between comprehensive rehabilitation program and traditional chest physiotherapy on weaning from mechanical ventilation, improvement of respiratory muscle strength, peripheral muscle strength and functional status.Methods Fifty mechanically ventilated general surgery patients from both sexes (men & women) with age from 40 to 50 years old participated in the present randomized clinical trial. They had difficult and prolonged weaning. They were divided randomly into two groups , group(A) consisted of twenty four patients who received comprehensive rehabilitation program combined with inspiratory muscle training and group(B) consisted of twenty six patients who received traditional chest physical therapy combined with inspiratory muscle training. Four patients in the study group and six subjects in the control group died during the intervention period and thus their data were excluded from the final analysis. Maximal inspiratory pressure (MIP), peripheral muscle strength and Functional independence measure questionnaire were measured at the beginning of the study and at weaning from mechanical ventilator.ResultsResults revealed that there was a significant improvement in days to wean and peripheral muscle strength in difficult and prolonged weaning patients in group A compared with group B. There was a significant improvement in maximal inspiratory pressure (MIP) in both groups. In addition, there was a significant increase in the median values of functional independence measures in group A more than group B.ConclusionsBoth physical therapy programs inspiratory muscle training and comprehensive rehabilitation and inspiratory muscle training and traditional chest physical therapy showed an increase in inspiratory muscle strength. On the other hand comprehensive program consisted of peripheral muscle training and functional training was more superior in decreasing days to wean and increasing peripheral muscle strength and functional independence measure score. The trial was prospectively registered at Clinicaltrials.gov ; Identifier: NCT04021615 ; date : 13-7-2019

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Section: Comparison Between Group a And Group B Post Trainingsupporting

confidence: 87%

Comprehensive Rehabilitation Program Versus Traditional Chest Physiotherapy for Weaning from Mechanical Ventilator ; randomized clinical trial

ELmoutaz¹,

Rahmy²,

Eldin³

et al. 2020

Preprint

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“…Nevertheless, it was confirmed that appropriate rehabilitation during hospital stay increases the BI approximately twofold and the weaning success by about 50% [21], while early mobilization is a positive independent factor contributing to being discharged home [23]. Ceriana et al [24] also demonstrated that, after rehabilitation during respiratory ICU stay, the mean Dependence Nursing Scale score improved, decreasing from 23 to 12 points.…”

Section: Discussionmentioning

confidence: 99%

Does the APACHE II score predict performance of activities of daily living in patients discharged from a weaning center?

Rojek-Jarmuła

Hombach

Krzych

2016

kitp

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IntroductionData regarding the functional status of patients after prolonged mechanical ventilation are scarce, and little is known about its clinical predictors.AimTo investigate whether the Acute Physiology and Chronic Health Evaluation (APACHE) II score on admission may predict performance in activities of daily living on discharge from a weaning center.Material and methodsAll consecutive patients admitted between January 1, 2012 and December 31, 2013 were enrolled (n = 130). During this period, 15 subjects died, and 115 were successfully discharged (34 women; 81 men). APACHE II was calculated based on the worst values taken during the first 24 hours after admission. On discharge, the Barthel Index (BI) and its extended version, the Early Rehabilitation Barthel Index (ERBI), were assessed.ResultsMedian BI was 20 points (IQR 5; 40), and ERBI was 20 points (–50; 40). There was no correlation between APACHE II and either BI (R = –0.07; p = 0.47) or ERBI (R = –0.07; p = 0.44). APACHE II predicted the need for assistance with bathing (AUROC = 0.833; p < 0.001), grooming (AUROC = 0.823; p < 0.001), toilet use (AUROC = 0.887; p < 0.001), and urination (AUROC = 0.658; p = 0.04). APACHE II had no impact on any ERBI items associated with ventilator weaning, including the need of further mechanical ventilation (AUROC = 0.534; p = 0.65) or tracheostomy (AUROC = 0.544; p = 0.42).ConclusionsAlthough APACHE II cannot predict the overall functional status in patients discharged from a weaning center, it helps identify subjects who will need support with bathing, grooming, and toilet use. The APACHE II score is inadequate to predict performance in activities associated with further respiratory support.

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“…Estudos conduzidos em pacientes críticos submetidos a VMI, admitidos em UTIs clínicas ou cirúrgicas, ou ainda em unidades respiratórias não mostraram diferenças no tempo de VMI (30)(31)(32) , tempo de internação na UTI (30,31,33) , frequência de pneumonia associada à ventilação mecânica (31) e mortalidade (30)(31)(32)(33) entre pacientes que recebiam assistência fisioterapêutica e pacientes do grupo controle, não assistidos pela fisioterapia.…”

Section: Impacto Da Assistência Fisioterapêutica Ao Paciente Crítico unclassified

“…A assistência fisioterapêutica oferecida nestes estudos consistia de uma (32) , duas (30,31) , ou seis (33) sessões diárias de fisioterapia respiratória que compreendia posicionamento, higiene brônquica e aspiração (30,31) ; ou treinamento de respiração abdominal e da musculatura respiratória, exercícios ativos e passivos de membros superiores e inferiores, e treino de mobilidade progressiva (32) ; ou ainda, exercícios para os músculos respiratórios, técnicas de re-expansão pulmonar e remoção de secreções brônquicas, quando apropriados (33) . Além da grande heterogeneidade de condições clínicas, padronização das técnicas realizadas e número amostral comprometido, estes estudos não focaram na duração do turno diário de assistência fisioterapêutica na UTI.…”

Section: Impacto Da Assistência Fisioterapêutica Ao Paciente Crítico unclassified

Impacto da assistência fisioterapêutica em unidade de terapia intensiva no tempo de ventilação mecânica, tempo de internação e custos do paciente cirúrgico

Silva¹

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Outcome of Physical Therapy Intervention on Ventilator Weaning and Functional Status

Cited by 16 publications

References 8 publications

Comprehensive Rehabilitation Program Versus Traditional Chest Physiotherapy for Weaning from Mechanical Ventilator ; randomized clinical trial

Comprehensive Rehabilitation Program Versus Traditional Chest Physiotherapy for Weaning from Mechanical Ventilator ; randomized clinical trial

Does the APACHE II score predict performance of activities of daily living in patients discharged from a weaning center?

Impacto da assistência fisioterapêutica em unidade de terapia intensiva no tempo de ventilação mecânica, tempo de internação e custos do paciente cirúrgico

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