Influence of Early Standing Training on ICU Patients
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 50
- 主要终点
- Timed Inspiration
研究概览
简要总结
Influence of early standing training on ICU patients
详细描述
Objective
To study the effect of early standing training on ICU patients.Background: Early severe rehabilitation is of great significance for patients, which can help patients withdraw from mechanical ventilation as soon as possible, improve pulmonary ventilation, and promote early walking.However, patients on mechanical ventilation are more prone to delirium, muscle weakness, ventilator dependence and other problems. Early standing training can significantly improve patients' lower limb muscle strength, improve diaphragm function, improve the prognosis of patients, and reduce the length of hospital stay.Methods: selecting stable hemodynamics in ICU patients with mechanical ventilation, randomly divided into two groups, a group of routine rehabilitation training, another group stand for regular rehabilitation and early training, with the aid of electric beds, on the first day of patients, to evaluate the seventh day, the 14th day, and collect the basic information for patients and strength assessment, blood gas analysis, the diaphragm of the bed and ultrasound and muscle ultrasound, and record the patient's mortality within 28 days, the incidence of delirium, decannulation rate, etc., recorded in patients with mechanical ventilation time and the time required to walk independently and ICU stay time.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Care Provider)
入排标准
- 年龄范围
- 18 Years 至 100 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •The age is ≥ 18 years old;
- •the hemodynamics is stable;
- •50 < heart rate < 120 beats / min ;
- •90 < systolic blood pressure < 200mmHg ;
- •55 < mean arterial pressure < 120mmHg;
- •do not increase the dose of pressor drugs for at least 2 hours;
- •intracranial pressure is stable and there are no seizures within 24 hours;
- •the respiratory state is stable;
- •the patient's finger pulse oxygen saturation ≥ 88%;
- •Oxygen concentration less than 60%；
- •Terminal positive expiratory pressure<12cmH2O；
- •10 < respiratory frequency < 35 beats / min.
排除标准
- •Pregnancy;
- •acute cardio-cerebrovascular events;
- •spinal or limb fractures;
- •active bleeding.
研究组 & 干预措施
control group
Conventional rehabilitation，Muscle training and breathing training
干预措施: Intensive rehabilitation (Behavioral)
experimental group
Early standing training and routine rehabilitation
干预措施: Intensive rehabilitation (Behavioral)
结局指标
主要结局
Timed Inspiration
时间窗: day 14
Normal adults are 1s
Medical Research Council
时间窗: day 14
Muscle strength assessment of ICU patients，Out of 60 points，Less than 48 points had acquired muscle weakness in the ICU.
Berg Balance Scale
时间窗: day 14
Balance grade score,The highest 56 points,The higher the score, the better the balance.
FIM Function Independent Scale
时间窗: day 14
Functional independence assessment,The lowest score is 18 and the highest is 126,The higher the score, the more independent it is.
Holden walk classification
时间窗: day 14
Levels 0 to 5,The higher the grade, the better the ability to walk
arterial blood gas analysis
时间窗: day 14
PH,normal range 7.35-7.45
partial pressure of carbon dioxide
时间窗: day 14
normal range 35-45 mmHg
oxygenation index
时间窗: day 14
Normal adults are 400,the higher，the better
lactic acid
时间窗: day 14
normal range 0.5-1.6mmol/L
Diaphragmatic movement
时间窗: day 14
The distance the diaphragm moves downward during inhalation,Normal adults are 1.4cm.
Diaphragm contraction rate
时间窗: day 14
Normal adults are 1.3cm/s
Diaphragm thickness at end of breath
时间窗: day 14
Normal adults are 0.15cm
Diaphragm thickness at end of inhalation
时间窗: day 14
Normal adults are 0.28cm
Diaphragmatic thickness variation rate
时间窗: day 14
Less than 20% have diaphragmatic dysfunction
E-T index
时间窗: day 14
Product of inspiratory time and diaphragmatic mobility,The higher the extubation success rate, the higher the extubation success rate.
Rectus femoris thickness
时间窗: day 14
The thicker the muscle, the better
Thickness of tibialis anterior muscle
时间窗: day 14
The thicker the muscle, the better
partial pressure of carbon dioxide
时间窗: day 7
normal range 35-45 mmHg
Berg Balance Scale
时间窗: day 1
Balance grade score,The highest 56 points,The higher the score, the better the balance.
Berg Balance Scale
时间窗: day 7
Balance grade score,The highest 56 points,The higher the score, the better the balance.
arterial blood gas analysis
时间窗: day 7
PH,normal range 7.35-7.45
Medical Research Council
时间窗: day 1
Muscle strength assessment of ICU patients，Out of 60 points，Less than 48 points had acquired muscle weakness in the ICU.
Medical Research Council
时间窗: day 7
Muscle strength assessment of ICU patients，Out of 60 points，Less than 48 points had acquired muscle weakness in the ICU.
FIM Function Independent Scale
时间窗: day 1
Functional independence assessment,The lowest score is 18 and the highest is 126,The higher the score, the more independent it is.
oxygenation index
时间窗: day 1
Normal adults are 400,the higher，the better
FIM Function Independent Scale
时间窗: day 7
Functional independence assessment,The lowest score is 18 and the highest is 126,The higher the score, the more independent it is.
Holden walk classification
时间窗: day 1
Levels 0 to 5,The higher the grade, the better the ability to walk
Holden walk classification
时间窗: day 7
Levels 0 to 5,The higher the grade, the better the ability to walk
arterial blood gas analysis
时间窗: day 1
PH,normal range 7.35-7.45
partial pressure of carbon dioxide
时间窗: day 1
normal range 35-45 mmHg
oxygenation index
时间窗: day 7
Normal adults are 400,the higher，the better
lactic acid
时间窗: day 1
normal range 0.5-1.6mmol/L
lactic acid
时间窗: day 7
normal range 0.5-1.6mmol/L
Diaphragmatic movement
时间窗: day 1
The distance the diaphragm moves downward during inhalation,Normal adults are 1.4cm.
Diaphragmatic movement
时间窗: day 7
The distance the diaphragm moves downward during inhalation,Normal adults are 1.4cm.
Diaphragm contraction rate
时间窗: day 1
Normal adults are 1.3cm/s
Diaphragm contraction rate
时间窗: day 7
Normal adults are 1.3cm/s
Diaphragm thickness at end of breath
时间窗: day 1
Normal adults are 0.15cm
Diaphragm thickness at end of breath
时间窗: day 7
Normal adults are 0.15cm
Diaphragm thickness at end of inhalation
时间窗: day 1
Normal adults are 0.28cm
Diaphragm thickness at end of inhalation
时间窗: day 7
Normal adults are 0.28cm
Diaphragmatic thickness variation rate
时间窗: day 1
Less than 20% have diaphragmatic dysfunction
Diaphragmatic thickness variation rate
时间窗: day 7
Less than 20% have diaphragmatic dysfunction
E-T index
时间窗: day 1
Product of inspiratory time and diaphragmatic mobility,The higher the extubation success rate, the higher the extubation success rate.
E-T index
时间窗: day 7
Product of inspiratory time and diaphragmatic mobility,The higher the extubation success rate, the higher the extubation success rate.
Timed Inspiration
时间窗: day 1
Normal adults are 1s
Timed Inspiration
时间窗: day 7
Normal adults are 1s
Rectus femoris thickness
时间窗: day 1
The thicker the muscle, the better
Rectus femoris thickness
时间窗: day 7
The thicker the muscle, the better
Thickness of tibialis anterior muscle
时间窗: day 1
The thicker the muscle, the better
Thickness of tibialis anterior muscle
时间窗: day 7
The thicker the muscle, the better
次要结局
- delirium(28 days)
- mortality(28 days)
- reintubation(28 days)
- Mechanical ventilation time(three months)
- icu length of stay(three months)
- Time required for independent walking(three months)
研究者
wang kaifei
Ph.D.
Chinese PLA General Hospital