Beruflich Dokumente
Kultur Dokumente
Clinical Question: Does early mobility and ambulation reduce post-intensive care
syndrome in acutely ventilator dependent adult trauma patients?
Critically injured patients have been challenged with lack of activity due to fear of tubes
and line loss, hemodynamic instability, personnel and equipment resources, patient discomfort,
patient size, time involved, along with activity intolerance, ( (Drolet, et al., 2013). Prolonged
bed rest in hospitalized patients leads to deconditioning, impaired mobility, and the potential for
longer hospital stays (Drolet et al., 2013, p. 197). These risks add to the already critical
2
Discussion of Literature
Early Physical and Occupational Therapy in Mechanically Ventilated, Critically Ill
Patients: A Randomized Controlled Trail, (Schweichert et al., 2009, p. 1874).
This is a level of evidence AACN rated level B randomized control trial, cohort study
evaluating the long-term complications of critical illness include intensive care unit (ICU)acquired weakness and neuropsychiatric disease. Immobilization secondary to sedation might
potentiate these problems (Schweickert et al., 2009, p. 1874). Therefore the sample setting
derived from sedated ventilator dependent patients from a sample size of 100 patients. The
measurement was early exercise and mobilization during periods of interrupted sedation,
measuring the number of patients who were able to perform six ADLs upon discharge, shorter
duration of delirium, and ventilator free days, (Schweickert et al., 2009, p. 1877). Data analysis
compared the effect of the treatment protocol on the time to return to independent function
using time-to-event analysis. Significant differences between groups or across time were
reported at the alpha level of 0.05. All reported p values are two sided, (Schweichert et al.,
2009, p. 1877). Comparison between study groups was from a two-sample rank sum t test,
(Schweichert et al., 2009, p. 1877).
The findings supported the strategy for whole-body rehabilitationaccomplished by
interruption of sedation, protocol-driven spontaneous breathing trials, physical and occupational
therapyresulted in better outcomes compared with current standard approaches to sedation and
activity during mechanical ventilation and its recovery. Patients assigned to intervention had
shorter duration of delirium and left the hospital with better functional status. This study
5
2009, p. 1874).
11