Chair-Sitting Exercise Intervention Does Not Improve Respiratory Muscle Function in Mechanically Ventilated Intensive Care Unit Patients
Chair-Sitting Exercise Intervention Does Not Improve Respiratory Muscle Function in Mechanically Ventilated Intensive Care Unit Patients
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DOI：
10.4187/respcare.00938
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发表时间：
2011-10-01
期刊：
影响因子：
2.5
通讯作者：
Cheng, Chien-Hsiang
中科院分区：
文献类型：
--
作者：
Chang, Mei-Yu;Chang, Li-Yin;Cheng, Chien-Hsiang
背景技术背景：椅子坐姿可以允许更容易地激活斜角肌、胸锁乳突肌和胸骨旁肋间肌，并且可以抬高和扩大上胸廓，从而允许胸廓更容易被压缩。目的：评价运动训练时坐椅对机械通气患者呼吸肌功能的影响。方法：我们将16例患者随机分配到对照组，18例患者随机分配到坐立组。坐位组由2名重症监护室护士将患者从床上转移到扶手椅上，并根据患者的耐受性休息至少30 min。我们测量心率、血压、S（pO 2）和呼吸频率。治疗组在患者从床上转移到扶手椅前和完成坐立后30 min测定呼吸肌功能指标，包括呼吸频率（f）/潮气量（V（T））、S（pO 2）、最大吸气压（P（Imax））和最大呼气压（P（Emax））。在对照组患者中，我们在患者半卧位、治疗前后至少6天或直到患者从重症监护室出院或死亡时进行了相同的测量。结果：两组在年龄、性别或临床结局方面没有显著差异。坐姿组的呼吸频率、V（T）、f/V（T）、S（pO 2）、P（Imax）和P（Emax）没有显著改善。研究期间呼吸频率、V（T）、P（Imax）和P（Emax）显著改善（均P < .001），但f/V（T）无改善。结论：6天的坐立运动训练没有显著改善机械通气患者的呼吸肌功能。
BACKGROUND: Chair-sitting may allow for more readily activated scalene, sternocleidomastoid, and parasternal intercostal muscles, and may raise and enlarge the upper thoracic cage, thereby allowing the thoracic cage to be more easily compressed. OBJECTIVE: To evaluate the effect of chair-sitting during exercise training on respiratory muscle function in mechanically ventilated patients. METHODS: We randomized 16 patients to a control group and 18 patients to a chair-sitting group. The patients in the chair-sitting group were transferred by 2 intensive care unit nurses from bed to armchair and rested for at least 30 min, based on the individual patient's tolerance. We measured heart rate, blood pressure, S(pO2), and respiratory rate. In the treatment group, before transferring the patient from bed to armchair, and 30 min after the completion of chair-sitting we measured respiratory muscle function variables, including the ratio of respiratory rate (f) to tidal volume (V(T)), S(pO2), maximum inspiratory pressure (P(Imax)) and maximum expiratory pressure (P(Emax)). In the control patients we took those same measurements while the patient was in semirecumbent position, before and after treatments, for at least 6 days or until the patient was discharged from the intensive care unit or died. RESULTS: The 2 groups did not significantly differ in age, sex, or clinical outcomes. Respiratory rate, V(T), f/V(T), S(pO2), P(Imax) and P(Emax) were not significantly better in the chair-sitting group. The study period significantly improved respiratory rate, V(T), P(Imax), and P(Emax) (all P < .001), but not f/V(T). CONCLUSIONS: Six days of chair-sitting exercise training did not significantly improve respiratory muscle function in mechanically ventilated patients.