The Effect Of Early Exercise Of Lower Limbs On The Gastrointestinal Function Of ICU Patients Received Mechanical Ventilation

Objectives: To investigate the effects of the early training of a bedside cycle ergometer to prevent or reduce gastrointestinal damage whether it is a safe and effective method.Methods: This was a Study on the method of prospective design of historical controls.The patients of study were who met the enrollment criteria from January 2013 to December 2014 in a general intensive care unit(ICU)of University hospital. Inclusion criteria: ① patients due to lung disease resulting in respiratory failure and received invasive mechanical ventilation therapy②without enteral nutrition contraindications;③age≥18 years of age. Exclusion criteria:①brain failure;②malignant tumor;③ pregnant women;④ The contraindications of the training of a bedside cycle ergometer. According to the patients in the intensive care unit on the basis of receiving conventional treatment,whether received the lower limbs treadmill exercise training divided into exercise group and the conventional group. The exercise group patients received lower limb treadmill exercise training for twenty minutes twice a day on the basis of receiving routine treatment.The main outcome measures included baseline characteristics of patients when enrolled,The gastrointestinal function abnormalities of the cumulative frequency within seven days after entering the group, nutrition-related indicators of the time of enrollment, the seventh days, at discharge, as well as prognostic indicators and treatment costs the patient at discharge.Results: Total of 102 patients were enrolled in the study, of which 52 patients received lower limb movement(the treatment group), 50 patients in conventional group(control group).There were no significant difference in baseline data of gender, age, BMI,infection-related indicators, and other ventilator treatment parameters(P>0.05).During 7days of the treatment of lower limb movement, compared with two groups of patients withgastrointestinal function abnormality, the rate of diarrhea, gastric retention in treatment group were significantly lower than the control group(P<0.05),and vomiting rate,compliance rate of early enteral nutrition(the third days) had no statistical difference(P>0.05).In addition, the increasing nutrition dose of exercise group compared with conventional enteral on seventh day had significant difference(P <0.05).Two groups of patients on seventh day, each nutrient parameter had no statistical difference(P> 0.05).And when they were discharged from the hospital, the albumin, pre-albumin and lymphocyte count were statistically significant(P <0.05). The invasive ventilation days, anti-infective cost in treatment group were less than the control group(P < 0.05). ICU length of stay and total hospitalization time, total cost of hospitalization between the two groups had no statistically significant difference(P> 0.05).Conclusion: The training of a bedside cycle ergometer helps reduce gastrointestinal damage and to improve the nutritional status,and reduce the time of mechanical ventilation and anti-infection treatment costs of ICU patients.