The Effect of Semi-recumbent Position With Exercise Training on Long-term Ventilator-dependent Patients

Taoyuan General Hospital

Status

Completed

Conditions

Position

Difficult Intubation

Mechanical Ventilation

Exercise

Treatments

Behavioral: 45 Degree Semi-recumbent Position With Upper Limb Exercise Training

Behavioral: no 45 Degree Semi-recumbent Position With Upper Limb Exercise Training

Study type

Interventional

Funder types

Other

Identifiers

NCT04822831

SeHLin

Details and patient eligibility

About

Prolonged mechanical ventilation patients rely on medical expenses per year had increased by nearly 20 billion in 15 years, so it is worthwhile to explore how to improve the respiratory function and even their quality of life of patients in Respiratory care wards (RCWs). This study used repeated experimental measurements and purpose sampling, and the investigators invited patients in respiratory care ward in northern Taiwan. They were randomly assigned to the experimental group and the control group. The experimental group was given 45 degree Semi-sitting 2 hrs and upper-limb exercise training 10 mins once a day. There were 29 prolonged mechanical ventilation (PMV) patients in the experimental group and 26 in the control group. Our conclusions showed that PMV patients can significantly improve the maximum inspiratory pressure (MIP) in the post-test while performed a 45-degree semi-sitting position with upper limb training for 4 weeks. The minute ventilation (MV) has a trend of increasing month by month in the experimental group, but it is necessary to consider whether it is due to the improvement of lung function or just cause of the increased oxygen consumption and accelerated respiratory rate, so it can not be inferred to improvement of the patient's condition or lung function.

Full description

Background: Prolonged mechanical ventilation patients rely on medical expenses per year had increased by nearly 20 billion in 15 years. However, the high cost shows the high morbidity rate, high mortality rate and low ventilator weaning rate of prolonged mechanical ventilation patients, so it is worthwhile to explore how to improve the respiratory function and even their quality of life of patients in the respiratory care ward (RCW).

OBJECTIVE: To investigate the improvement of respiratory function and the effect of respirator detachment in 45-degree semi-sitting and upper limb training, and to understand the correlation between this training activity and death risk.

METHODS: This study used repeated experimental measurements and purpose sampling, and the investigators invited patients in the respiratory care ward (RCW) in northern Taiwan. They were randomly assigned to the experimental group and the control group. The experimental group was given 45 degree Semi-sitting 2hrs and upper-limb exercise training 10mins once a day. After 4 weeks, the investigators measure the respiratory parameters such as the maximum inspiratory pressure (MIP), the tidal volume (VT), the minute ventilation (MV), and the rapid shallow breathing index(RSBI) of these two groups, and used the generalized estimating equation (GEE) to compare with them.

Enrollment

60 patients

Sex

All

Ages

20 to 89 years old

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria

respiratory care ward (RCW) cases using mechanical ventilators
20 years old ≦ age ≦ 89 years old
Those who used antibiotics without infection and fever (body temperature >38.5℃) in the past 3 days
the fraction of inspiration O2(FiO2)≦50% and the positive end expiratory pressure(PEEP)≦10
90 mm-Hg≦ systolic blood pressure(SBP) ≦160 mm-Hg
60 beats/min≦ heart rate(HR) ≦130 beats/min without arrhythmia
12 times/min≦ respiratory rate(RR) ≦35 times/min
90%≦ oxygen saturation by pulse oximetry (SPO2) ≦100%
Patients with spontaneous breathing
Digestible without continuous feeder

Exclusion Criteria:

respiratory care ward (RCW) cases without mechanical ventilators
Age <20 years old or age>89 years old
Those who have been infected with fever in the past 3 days (body temperature >38.5℃) and are taking antibiotic
the fraction of inspiration O2(FiO2) >50% and the positive end expiratory pressure(PEEP)>10
systolic blood pressure(SBP)< 90 mm-Hg or systolic blood pressure(SBP) >160 mm-Hg
heart rate(HR)<60 beats/min or heart rate(HR)>130 beats/min and arrhythmia
respiratory rate(RR)<12 times/minute or respiratory rate(RR)>35 times/minute
oxygen saturation by pulse oximetry (SPO2) <90%
Patients without spontaneous breathing
Poor digestion and use of continuous feeders