The Effect Of Mobilization On Short-Term Functional Status Of Critically Ill Patients In ICU

Background:The intensive care unit(ICU)is a multi-disciplinary,multi-functional medical unit for critically ill patients in hospitals to ensure maximum patient survival.With the development of critical care,the survival rate of critically ill patients has been significantly improved,but the number of patients with long-term dysfunction has also increased.In the domestic comprehensive ICU,critically ill patients generally need to stay in bed,and long-term braking is a risk factor for multiple dysfunctions.Most surviving critically ill patients still have short-term or long-term dysfunction after discharge.Evidence has shown that proper activities contribute to the proper functioning and conditioning of the various systems of the body,and that functions such as muscles,joints,lungs,heart and cognition rely on active applications to maintain function.Patients may have a better prognosis when bed rest and activity are balanced.At present,there is evidence that early rehabilitation treatment for critically ill patients is safe,feasible and effective,but the rehabilitation of ICU in China is still in its infancy,and many clinical medical staff lack understanding of the importance of severe rehabilitation,and there are few related studies.Rehabilitation treatment is usually carried out after the patient has been mechanically ventilated for about 1 week or offline.The therapeutic effect of rehabilitation therapy on critically ill patients is not clear.ObjectiveThis study aimed to investigate the effect of mobilization on short-term functional status of critically ill patients in ICU.MethodsSeventy-eight eligible ICU critically ill patients in intensive care unit of the Anhui Provincial Hospital of Anhui Medical University from October 2016 to September 2017 and met the above criteria were randomly divided into the control group and the observation group.Ten patients died during the ICU(including 4 in the observation group and 6 in the control group),and 68 patients eventually completed the study.Both groups of patients were given ICU routine care,including: maintaining internal environment stability;anti-infective treatment;nutritional support;continuous 24-hour ECG monitoring;keeping the airway open,regularly turning over the back;after excluding the taboo,raising the bed head 30 Symptomatic treatment such as-45°.On the basis of this,patients in the observation group were assisted by a rehabilitation therapist for exercise training.The assessment is first performed before each day of training to determine whether the patient can be trained and choose the appropriate training level.The sports training is divided into 5 levels.The full range of passive joints is performed for comatose patients,and the progressive comprehensive exercise training is performed for patients with high degree of fit.The intensity of treatment should be adjusted according to the patient’s completion,and try to select the highest level of training that the patient can complete.Before exercise and after leaving the ICU(after treatment),Medical research council(MRC),incidence of intensive care unitacquired weakness(ICU-AW)and lower extremity deep venous thrombosis(LDVT),exercise grade,Functional ambulation category scale(FAC),the number of days of sedation and vasopressors,intensive care unit length of stay,hospital costs and discharged whereabouts were compared.Data were statistically analyzed using SPSS version 17.0 statistical software.ResultsAfter treatment,there was no significant difference between the two groups in hospital costs and the number of days of vasopressors(p> 0.05).The MRC score of the observation group was significantly higher than that of the control group.The incidence of ICU-AW and LDVT,intensive care unit length of stay and the number of sedation days were less than those of the control group.After discharge,more people choose rehabilitation.The above differences were statistically significant(p <0.05).ConclusionICU mobilization can effectively increase limb muscle strength,improve walking function,reduce the incidence of ICU-AW and LDVT,shorten the time of intensive care unit length of stay and sedation drug use.