Early physical rehabilitation in intensive care patients with sepsis syndromes: a pilot randomised controlled trial
Early physical rehabilitation in intensive care patients with sepsis syndromes: a pilot randomised controlled trial
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DOI：
10.1007/s00134-015-3763-8
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发表时间：
2015-05-01
影响因子：
38.9
通讯作者：
Paratz, Jennifer
中科院分区：
文献类型：
--
作者：
Kayambu, Geetha;Boots, Robert;Paratz, Jennifer
脓毒症综合征的幸存者的身体和认知功能预后不良。为了确定早期物理康复是否能改善脓毒症综合征患者的身体功能和相关结果，50名因脓毒症综合征入住普通重症监护室的危重成人被招募到一个前瞻性的双重研究中，研究早期身体康复的盲法随机对照试验：身体功能的主要结果在ICU出院时和出院后6个月记录急性护理功能指数和自我报告的健康相关生活质量，分别次要指标包括炎症生物标志物;白细胞介素-6、白细胞介素-10和肿瘤坏死因子-α、血乳酸、无脂肪肌肉质量、运动能力、肌肉力量和焦虑。在运动组中发现6个月时SF-36的作用（81.8 +/- A 22.2 vs. 60.0 +/- A 29.4），p = 0.04）和身体作用（61.4 +/-A 43.8 vs. 17.1 +/- A 34.4，p = 0.005）。两组之间的身体机能评分没有显着差异。肌肉力量评分为（51.9 +/- A 10.5 vs. 47.3 +/- A 13.6，p = 0.24），标准治疗平均医学研究理事会肌肉评分（MRC）< 48/60。白细胞介素-10的平均变化增加，运动组显著更高（1.8 pg/ml，180% vs. 0.9 pg/ml，90%，p = 0.04）。两组间乳酸、白细胞介素-6、肿瘤坏死因子-α、肌力、运动能力、无脂肪肿块或住院焦虑无显著差异。实施早期身体康复可改善自我报告的身体功能并诱导全身抗炎作用。
Survivors of sepsis syndromes have poor outcomes for physical and cognitive function. No investigations of early physical rehabilitation in the intensive care unit have specifically targeted patients with sepsis syndromes.To determine whether early physical rehabilitation improves physical function and associated outcomes in patients with sepsis syndromes.Fifty critically ill adults admitted to a general intensive care unit with sepsis syndromes were recruited into a prospective double-blinded randomised controlled trial investigating early physical rehabilitation.Primary outcomes of physical function (acute care index of function) and self-reported health-related quality of life were recorded at ICU discharge and 6 months post-hospital discharge, respectively. Secondary measures included inflammatory biomarkers; Interleukin-6, Interleukin-10 and tumour necrosis factor-alpha, blood lactate, fat-free muscle mass, exercise capacity, muscle strength and anxiety.A significant increase in patient self-reported physical function (81.8 +/- A 22.2 vs. 60.0 +/- A 29.4), p = 0.04) and physical role (61.4 +/- A 43.8 vs. 17.1 +/- A 34.4, p = 0.005) for the SF-36 at 6 months was found in the exercise group. Physical function scores were not significantly different between groups. Muscle strength scores were (51.9 +/- A 10.5 vs. 47.3 +/- A 13.6, p = 0.24) with the standard care mean Medical Research Council Muscle Score (MRC) < 48/60. The mean change of Interleukin-10 increased and was significantly higher in the exercise group (1.8 pg/ml, 180 % vs. 0.9 pg/ml, 90 %, p = 0.04). There was no significant difference between groups for lactate, Interleukin-6, tumour necrosis factor-alpha, muscle strength, exercise capacity, fat-free mass or hospital anxiety.Implementation of early physical rehabilitation can improve self-reported physical function and induce systemic anti-inflammatory effects.