Influence of Early Standing Training on ICU Patients
- Conditions
- Pulmonary Disease
- Registration Number
- NCT04460391
- Lead Sponsor
- Chinese PLA General Hospital
- Brief Summary
Influence of early standing training on ICU patients
- Detailed Description
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.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 50
- 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.
- Pregnancy;
- acute cardio-cerebrovascular events;
- spinal or limb fractures;
- active bleeding.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Primary Outcome Measures
Name Time Method Medical Research Council 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 day 14 Balance grade score,The highest 56 points,The higher the score, the better the balance.
FIM Function Independent Scale 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 day 14 Levels 0 to 5,The higher the grade, the better the ability to walk
partial pressure of carbon dioxide day 14 normal range 35-45 mmHg
oxygenation index day 14 Normal adults are 400,the higher，the better
lactic acid day 14 normal range 0.5-1.6mmol/L
Diaphragmatic movement day 14 The distance the diaphragm moves downward during inhalation,Normal adults are 1.4cm.
Diaphragm contraction rate day 14 Normal adults are 1.3cm/s
Diaphragm thickness at end of breath day 14 Normal adults are 0.15cm
Diaphragm thickness at end of inhalation day 14 Normal adults are 0.28cm
Diaphragmatic thickness variation rate day 14 Less than 20% have diaphragmatic dysfunction
E-T index day 14 Product of inspiratory time and diaphragmatic mobility,The higher the extubation success rate, the higher the extubation success rate.
Timed Inspiration day 14 Normal adults are 1s
Rectus femoris thickness day 14 The thicker the muscle, the better
Thickness of tibialis anterior muscle day 14 The thicker the muscle, the better
arterial blood gas analysis day 14 PH,normal range 7.35-7.45
- Secondary Outcome Measures
Name Time Method Mechanical ventilation time three months Mechanical ventilation time
icu length of stay three months icu length of stay
Time required for independent walking three months Time required for independent walking
delirium 28 days Confusion Assessment Method of the Intensive Care Unit. Positive is delirium.
mortality 28 days mortality
reintubation 28 days Note whether intubation was performed within 28 days.