Construction Of Early Active Activity Program For ICU Mechanically Ventilated Patients Based On Perme Score

Objective: Based on the Perme Intensive Care Unit Mobility Score,with referring to the early active activity experience at home and abroad and the current status of activities in China,an economical,practical and suitable early active activity program for ICU mechanically ventilated patients was constructed,which can provide a basis for these patients to carry out early active activities smoothly,so that it can promote the early rehabilitation of ICU patients.Methods:1.Literature review: Databases including the Cochrane Library,Pub Med,Web of Science,Embase,Sino Med,CNKI,VIP and Wanfang database were searched for literature on early mobilisation of ICU patients from inception to March,2020.After that,we initially constructed a draft of early active activities for ICU mechanically ventilated patients after extracting relevant information.2.Delphi Method: We used the Delphi method to consult with 30 experts,and used Excel 2019 and SPSS 25.0 to conduct statistical analysis on the data.After that,we revised the program based on the inclusion criteria of items and expert opinions,and finally established the early active activity program for ICU mechanically ventilated patients based on the Perme Intensive Care Unit Mobility Score.Results:1.Literature review: A total of 9643 articles were retrieved in this study.After excluding 819 duplications,we screened articles according to the inclusion and exclusion criteria,and 49 articles were eventually enrolled.After analyzing the literature and discussing in our group,four dimensions were summarized for constructing an early active activity program for ICU mechanically ventilated patients,including safety standards,contraindications,suspension indications,and specific activity program.2.Delphi Method:（1）Thirty experts from 11 different provinces were consulted,all from four fields of intensive medicine,rehabilitation medicine,intensive care and respiratory therapy.（2）The effective recovery rate of the two rounds of questionnaires was 100%,and the average authority coefficient of experts was 0.8558.（3）The Kendall’s of the importance and feasibility of each item in the first round of consultation were 0.271 and 0.225 respectively（P<0.05）,a total of 1 first-level entry,2 second-level entries,and 7 third-level entries were added;1 third-level entry was deleted;2 thirdlevel entries were modified.The Kendall’s of the importance and feasibility of each item in the second round of consultation were 0.285 and 0.228 respectively（P<0.05）,a total of 1 second-level entry and 1 third-level entry were added;1 third-level entry was deleted;4 third-level entries were modified.Conclusion: The experts in this study come from different regions and their research directions involve different fields.They are representative,active,authoritative,and coordinated,indicating that the early active activity program for ICU mechanically ventilation patients is scientific and reliable.Therefore,this program can provide a reference for the early active activities of ICU mechanically ventilated patients.Besides,it is of great significance for further constructing a theoretical evaluation system for early rehabilitation of ICU patients.