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Evaluation of the effect of pulmonary rehabilitation on patients with high flow oxygen therapy
Objective: the purpose of this study was to evaluate the effect of lung rehabilitation on patients treated with high flow humidification apparatus in ICU. Methods: 70 patients in ICU who were treated with high flow humidification apparatus from June 2019 to June 2020 were randomly divided into two groups. The experimental group was treated with pulmonary rehabilitation and the control group was treated with routine medical treatment only. All patients were evaluated and measured by bedside diaphragm ultrasound. The vital signs of all patients were monitored every day. MRCsum assessment of peripheral muscle strength, 30s sitting test, modified Barthel index, Borg dyspnea score, arterial blood gas analysis and bedside diaphragm ultrasound monitoring were performed at admission and discharge. Finally, statistics were made on the use of non-invasive ventilator, endotracheal intubation, new complications (pressure sore, aspiration, thrombus, etc.) and the time of patients getting out of bed for the first time.The end point of the experiment was 28 days.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental group | Experimental | Pulmonary rehabilitation therapy |
|
| Control group | No Intervention | Routine medical treatment |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Pulmonary rehabilitation therapy | Behavioral | Comprehensive interventions based on comprehensive evaluation and customization of patients, including, but not limited to, exercise training, education and behavioral changes, aimed at improving the physiological and psychological status of patients with chronic respiratory diseases, and urge patients to adhere to health promotion activities for a long time. |
| Measure | Description | Time Frame |
|---|---|---|
| MRC | Medical Research Council,Muscle strength assessment,total points0~60,less than 48scores means ICU aquired weaknesses. | Day 28 |
| STS | Number of sit-to-stand test in 30s,Muscle endurance assessment,The more times, has the better muscular endurance. | Day 28 |
| barthel index | barthel index,Daily activity assessment,Assessment of activities of daily living.total points0~100,less than 60 scores means can't independent living. | Day 28 |
| Borg dyspnea score | Borg dyspnea score,Maximum 10 points,Minimum 0,The higher the score, the harder it is to breathe | Day 28 |
| PaO2 | arterial partial pressure of oxygen,Partial pressure of oxygen in arterial blood,normal range is 80~100. | Day 28 |
| Oxygenation index | arterial partial pressure of oxygen divided by the oxygen concentration,Normal is greater than 400. | Day 28 |
| Diaphragm mobility | The distance the diaphragm drops during inhalation,normal is 1.4cm. | Day 28 |
| Diaphragm contraction velocity |
| Measure | Description | Time Frame |
|---|---|---|
| ICU stay time | icu length of stay | 3 month |
| Hospitalization time | Hospitalization time,length of stay in hospital. | Month 3 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| kai fei Wang | Contact | +861055499330 | 17600953801 | zhaoying301301@163.com |
| Name | Affiliation | Role |
|---|---|---|
| wang, doctor | The First Medical Center of PLA General Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Chinese PLAGH Hospital | Recruiting | Beijing | Beijing Municipality | China |
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| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| ID | Term |
|---|---|
| D012140 | Respiratory Tract Diseases |
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The rate at which the diaphragm contracts during inhalation,normal is 1.3cm/s.
| Day 28 |
| End-inspiratory diaphragm thickness | The thickness of the diaphragm during inhalation,The thickness of diaphragm at the end of expiratory is about 0.25cm. | Day 28 |
| End-expiratory diaphragm thickness | The thickness of the diaphragm during exhalation,The thickness of diaphragm at the end of expiratory is about 0.15cm. | Day 28 |
| Diaphragm thickness variation rate | Rate of diaphragmatic thickness change during breathing,Diaphragmatic dysfunction is considered less than 20%. | Day 28 |
| The time it takes to get out of bed for the first time | The time it takes to get out of bed for the first time | Day 28 |
| Use of non-invasive ventilator | Use of non-invasive ventilator,Whether to use non-invasive ventilator within 28 days. | Day 28 |
| Intubation | Intubation,Whether endotracheal intubation was performed for invasive mechanical ventilation within 28 days | Day 28 |
| mortality | mortality | Day 28 |
| Complication | The incidence of new complications(pressure sores、thrombus、aspiration). | Day 28 |