Background: Critically ill patients receiving prolonged mechanical ventilatory support are at risk for loss of muscle mass and muscle strength from immobility. Feasible, non-invasive methods are needed to accurately o...Background: Critically ill patients receiving prolonged mechanical ventilatory support are at risk for loss of muscle mass and muscle strength from immobility. Feasible, non-invasive methods are needed to accurately obtain data on markers of muscle mass to design effective interventions and monitor patient progress during recovery from critical illness. Bioelectric impedance has been used in other settings to obtain data on body composition and muscle mass. Purpose: The aims of this study were to determine the feasibility of bioelectric impedance as a marker of muscle mass in a sample of mechanically ventilated patients and to assess data trends in these obtained values. Methods: A descriptive design was used to obtain standard bioelectric impedance parameters (total body resistance, legs resistance, and percent lean body mass) over 4 days from eligible patients already enrolled in a randomized clinical trial. Results: Bioimpedance parameters were readily obtained over 4 days in a sample of 43 patients (age 59 + 15.7 years, 56% male) receiving prolonged ventilatory support (mean 9.4 + 10.4 days) due to respiratory failure. Reasons for not obtaining impedance measures included skin impairment, monitoring devices, or presence of implantable cardiac defibrillator or pacemaker. Average total body impedance was 464.3 + 117.1 ohms, while average impedance of legs was 479.1 + 146.4 ohms. Lean body mass was 68.4% (+10.8). Conclusions/Implications for Practice: With carefully trained staff and a standardized measurement protocol, bioimpedance is a feasible method to obtain body composition data reflective of muscle mass in mechanically ventilated patients. Further research will determine the utility of bioimpedance to monitor recovery and effectiveness of interventions to restore function after prolonged periods of ventilatory support and immobility in mechanically ventilated patients.展开更多
Hospital-acquired infections (HAI) reflect as a major global safety concern for both patients and health-care professionals. These infections could be in the form of cross-infection, endogenous infection and environme...Hospital-acquired infections (HAI) reflect as a major global safety concern for both patients and health-care professionals. These infections could be in the form of cross-infection, endogenous infection and environmental Infection. Over 80% of these infections are related to devices’ utilization needed for patients’ life support. Methods show this is an observational and cross-sectional study, to identify the microorganism and determine the potential source of transmitting of hospital acquired infection by routine devices in adult ICU. The samples were collected using Amies transport media;three swabs were taken from the surfaces of indwelling urinary catheter, mechanical ventilation device and central venous catheter used from every twelve patients. The samples were cultured and analyzed by using microbiologic technique. Finally, all samples analyzed by MicroScan WalkAway 96 pulse. Results showing the most bacteria isolated are “Klebsiella pneumonia” (18.37%), “Acinetobacter baumannii” (11.48%), “Staphylococcus epidermidis” (4.59%), “Staphylococcus haemolyticus” (4.59%), “E. coli” (4.59%), “Serratia marcescens” (2.3%), “Pseudomonas luteola” (2.3%), “Kocurio kristinae” (2.3%) and “Photorhabdus luminscens” (2.3%). This study detects a high contamination of routine devices and resistant organisms. In the end it is recommended that effective infection control practices and effective strategies to control antibiotic-resistant bacteria should be applied.展开更多
目的探究早期多元化活动护理干预对重症监护病房(intensive care unit,ICU)机械通气患者预防获得性衰弱的效果。方法随机选取2020年10月—2022年10月于福建中医药大学附属人民医院就诊的112例ICU机械通气患者为研究样本,根据随机数表法...目的探究早期多元化活动护理干预对重症监护病房(intensive care unit,ICU)机械通气患者预防获得性衰弱的效果。方法随机选取2020年10月—2022年10月于福建中医药大学附属人民医院就诊的112例ICU机械通气患者为研究样本,根据随机数表法分为对照组及观察组,每组56例。对照组接受ICU常规护理,基于此给予观察组早期多元化活动护理。比较两组护理前后肌力(Medical Research Council,MRC)评分、日常生活能力评定量表(Activities of Daily Living,ADL)评分、临床相关时间指标、获得性衰弱发生率。结果两组护理前MRC评分、ADL评分对比,差异无统计学意义(P>0.05);观察组护理后MRC评分、ADL均高于对照组,差异有统计学意义(P<0.05)。观察组机械通气时间、ICU住院时间、总住院时间均短于对照组,差异有统计学意义(P<0.05)。观察组获得性衰弱发生率为96.43%,低于对照组的76.79%,差异有统计学意义(χ^(2)=9.314,P<0.05)。结论对ICU机械通气患者实施早期多元化活动护理可以有效提高肌力水平,降低脱机困难及获得性衰弱发生率,缩短机械通气时间及住院时间,并改善生活活动能力。展开更多
目的 探究多学科协作诊治(multidisciplinary team,MDT)主导心肺康复训练对ICU获得性衰弱患者机体活动能力的影响。方法 选取2020年5月—2023年5月在福建中医药大学附属人民医院接受重症监护室(intensive care unit,ICU)获得性衰弱护理...目的 探究多学科协作诊治(multidisciplinary team,MDT)主导心肺康复训练对ICU获得性衰弱患者机体活动能力的影响。方法 选取2020年5月—2023年5月在福建中医药大学附属人民医院接受重症监护室(intensive care unit,ICU)获得性衰弱护理治疗的患者60例,采用数字随机分组法分为观察组和对照组,两组各30例。对照组采用常规护理方案,观察组在对照组的基础上采用在MDT主导下的早期心肺康复训练进行干预。记录两组患者的机械通气时长和ICU住院时长;使用医学研究理事会(medical research council,MRC)肌力评定法评定两组患者治疗前后的肌力评分;比较两组患者干预前后切尔西危重患者身体功能评估工具(the chelsea critical care physical assessment tool,CPAx)及自理能力评估量表(Barthel)评分。结果 观察组患者的机械通气时长及ICU住院时长均短于对照组(P <0.05);干预后,观察组患者的MRC评分高于对照组(P <0.05);观察组患者CPAx评分及Barthel评分均高于对照组(P <0.05)。结论 MDT主导心肺康复训练能够帮助ICU获得性衰弱患者有效地恢复机体活动能力,缩短住院治疗的时间,改善患者肌力水平,提高自主生活的能力。展开更多
目的探讨早期活动预防慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)机械通气患者ICU获得性衰弱(intensive care unit acquired weakness,ICU-AW)的效果。方法 2014年1月至2015年10月,采用便利抽样法选择南通市瑞慈医...目的探讨早期活动预防慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)机械通气患者ICU获得性衰弱(intensive care unit acquired weakness,ICU-AW)的效果。方法 2014年1月至2015年10月,采用便利抽样法选择南通市瑞慈医院重症医学科收治的80例COPD机械通气患者为研究对象,按入院先后将其分为对照组和观察组各40例,对照组患者给予常规护理,观察组患者在对照组的基础上进行早期活动,评价并比较两组患者干预前后的医学研究理事会评分(Medical Research Council score,MRC-score)及干预后ICU-AW的发生率。结果干预后,观察组与对照组MRC-Score评分均高于干预前,观察组评分高于对照组,差异均有统计学意义(均P<0.05);观察组和对照组ICU-AW的发生率分别为2.5%(1/40)、40%(16/40),两组比较,差异有统计学意义(P<0.05)。结论在保证安全,严格筛选适应证、禁忌证的前提下,早期活动预防COPD机械通气患者并发ICU-AW效果较好,值得在临床推广应用。展开更多
文摘Background: Critically ill patients receiving prolonged mechanical ventilatory support are at risk for loss of muscle mass and muscle strength from immobility. Feasible, non-invasive methods are needed to accurately obtain data on markers of muscle mass to design effective interventions and monitor patient progress during recovery from critical illness. Bioelectric impedance has been used in other settings to obtain data on body composition and muscle mass. Purpose: The aims of this study were to determine the feasibility of bioelectric impedance as a marker of muscle mass in a sample of mechanically ventilated patients and to assess data trends in these obtained values. Methods: A descriptive design was used to obtain standard bioelectric impedance parameters (total body resistance, legs resistance, and percent lean body mass) over 4 days from eligible patients already enrolled in a randomized clinical trial. Results: Bioimpedance parameters were readily obtained over 4 days in a sample of 43 patients (age 59 + 15.7 years, 56% male) receiving prolonged ventilatory support (mean 9.4 + 10.4 days) due to respiratory failure. Reasons for not obtaining impedance measures included skin impairment, monitoring devices, or presence of implantable cardiac defibrillator or pacemaker. Average total body impedance was 464.3 + 117.1 ohms, while average impedance of legs was 479.1 + 146.4 ohms. Lean body mass was 68.4% (+10.8). Conclusions/Implications for Practice: With carefully trained staff and a standardized measurement protocol, bioimpedance is a feasible method to obtain body composition data reflective of muscle mass in mechanically ventilated patients. Further research will determine the utility of bioimpedance to monitor recovery and effectiveness of interventions to restore function after prolonged periods of ventilatory support and immobility in mechanically ventilated patients.
文摘Hospital-acquired infections (HAI) reflect as a major global safety concern for both patients and health-care professionals. These infections could be in the form of cross-infection, endogenous infection and environmental Infection. Over 80% of these infections are related to devices’ utilization needed for patients’ life support. Methods show this is an observational and cross-sectional study, to identify the microorganism and determine the potential source of transmitting of hospital acquired infection by routine devices in adult ICU. The samples were collected using Amies transport media;three swabs were taken from the surfaces of indwelling urinary catheter, mechanical ventilation device and central venous catheter used from every twelve patients. The samples were cultured and analyzed by using microbiologic technique. Finally, all samples analyzed by MicroScan WalkAway 96 pulse. Results showing the most bacteria isolated are “Klebsiella pneumonia” (18.37%), “Acinetobacter baumannii” (11.48%), “Staphylococcus epidermidis” (4.59%), “Staphylococcus haemolyticus” (4.59%), “E. coli” (4.59%), “Serratia marcescens” (2.3%), “Pseudomonas luteola” (2.3%), “Kocurio kristinae” (2.3%) and “Photorhabdus luminscens” (2.3%). This study detects a high contamination of routine devices and resistant organisms. In the end it is recommended that effective infection control practices and effective strategies to control antibiotic-resistant bacteria should be applied.
文摘目的探究早期多元化活动护理干预对重症监护病房(intensive care unit,ICU)机械通气患者预防获得性衰弱的效果。方法随机选取2020年10月—2022年10月于福建中医药大学附属人民医院就诊的112例ICU机械通气患者为研究样本,根据随机数表法分为对照组及观察组,每组56例。对照组接受ICU常规护理,基于此给予观察组早期多元化活动护理。比较两组护理前后肌力(Medical Research Council,MRC)评分、日常生活能力评定量表(Activities of Daily Living,ADL)评分、临床相关时间指标、获得性衰弱发生率。结果两组护理前MRC评分、ADL评分对比,差异无统计学意义(P>0.05);观察组护理后MRC评分、ADL均高于对照组,差异有统计学意义(P<0.05)。观察组机械通气时间、ICU住院时间、总住院时间均短于对照组,差异有统计学意义(P<0.05)。观察组获得性衰弱发生率为96.43%,低于对照组的76.79%,差异有统计学意义(χ^(2)=9.314,P<0.05)。结论对ICU机械通气患者实施早期多元化活动护理可以有效提高肌力水平,降低脱机困难及获得性衰弱发生率,缩短机械通气时间及住院时间,并改善生活活动能力。
文摘目的 探究多学科协作诊治(multidisciplinary team,MDT)主导心肺康复训练对ICU获得性衰弱患者机体活动能力的影响。方法 选取2020年5月—2023年5月在福建中医药大学附属人民医院接受重症监护室(intensive care unit,ICU)获得性衰弱护理治疗的患者60例,采用数字随机分组法分为观察组和对照组,两组各30例。对照组采用常规护理方案,观察组在对照组的基础上采用在MDT主导下的早期心肺康复训练进行干预。记录两组患者的机械通气时长和ICU住院时长;使用医学研究理事会(medical research council,MRC)肌力评定法评定两组患者治疗前后的肌力评分;比较两组患者干预前后切尔西危重患者身体功能评估工具(the chelsea critical care physical assessment tool,CPAx)及自理能力评估量表(Barthel)评分。结果 观察组患者的机械通气时长及ICU住院时长均短于对照组(P <0.05);干预后,观察组患者的MRC评分高于对照组(P <0.05);观察组患者CPAx评分及Barthel评分均高于对照组(P <0.05)。结论 MDT主导心肺康复训练能够帮助ICU获得性衰弱患者有效地恢复机体活动能力,缩短住院治疗的时间,改善患者肌力水平,提高自主生活的能力。
文摘目的探讨早期活动预防慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)机械通气患者ICU获得性衰弱(intensive care unit acquired weakness,ICU-AW)的效果。方法 2014年1月至2015年10月,采用便利抽样法选择南通市瑞慈医院重症医学科收治的80例COPD机械通气患者为研究对象,按入院先后将其分为对照组和观察组各40例,对照组患者给予常规护理,观察组患者在对照组的基础上进行早期活动,评价并比较两组患者干预前后的医学研究理事会评分(Medical Research Council score,MRC-score)及干预后ICU-AW的发生率。结果干预后,观察组与对照组MRC-Score评分均高于干预前,观察组评分高于对照组,差异均有统计学意义(均P<0.05);观察组和对照组ICU-AW的发生率分别为2.5%(1/40)、40%(16/40),两组比较,差异有统计学意义(P<0.05)。结论在保证安全,严格筛选适应证、禁忌证的前提下,早期活动预防COPD机械通气患者并发ICU-AW效果较好,值得在临床推广应用。
