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Register a new userThe Effect of Physiotherapy on Weaning and Length of Stay of Mechanically Ventilated Patients in Intensive Care Units
تأثير العلاج الفيزيائي على الفطام ومدة إقامة مرضى التنفس الآلي في وحدة الرعاية المركزة
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سوسن غزال( باحث )
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يهدف البحث إلى تقييم تأثير العلاج الفيزيائي على فطام المريض عن جهاز التنفس الآلي وطول مدة إقامته في وحدة الرعاية المركزة (ICU). تم تقسيم المرضى إلى مجموعتين. تلقت المجموعة الضابطة الرعاية التمريضية الروتينية. وقد تم الحصول على البيانات من المرضى الذين لا يتلقون العلاج الفيزيائي من سجلات المستشفى. بينما أخضعت المجموعة التجريبية لبرنامج العلاج الفيزيائي. أجري هذا البحث على عينة قوامها 30 مريضاً ومريضة موضوعين على جهاز التهوية الآلية في وحدات الرعاية المركزة بمشفى الأسد الجامعي. تم تقييم المعلومات الديموغرافية، والدراسات التشخيصية، ووجود أمراض مزمنة، والقياسات التنفسية عند القبول، وشدة الحالة الكلية للمريض بمقياس وظائف الأعضاء الحادة و الصحة المزمنة، نتائج المريض، ومدة الإقامة في وحدة الرعاية المركزة، ومدة الدعم بالتنفس الآلي، والمضاعفات. حيث تمت مقارنة وقت نزع الأنبوب وطول مدة البقاء في وحدة الرعاية المركزة بين المجموعتين. وكانت مدة الاعتماد على جهاز التنفس الآلي عند مرضى المجموعة الضابطة أطول منها عند مرضى المجموعة التجريبية، بفروق ذات دلالة إحصائية (P <0.05). كما لوحظ أن مدة الإقامة في وحدة الرعاية المركزة كانت أقل في المجموعة التجريبية مما كانت عليه في المجموعة الضابطة بفروق ذات دلالة إحصائية (P <0.05). وعلى الرغم من أن المرضى متماثلون في التشخيص والخصائص الجسمانية إلا أن طول مدة الإقامة في وحدة الرعاية المركزة كانت أقل في المجموعة الضابطة بفروق ذات دلالة إحصائية. أظهرت النتائج أن العلاج الفيزيائي له تأثير كبير في تقليل اعتماد المريض على أجهزة التنفس الآلي وتقصير مدة الإقامة في وحدة الرعاية المركزة
The aim of this study was to assess the effect of physiotherapy on ventilator weaning and lengths of intensive care unit (ICU) stay. Patients were divided into two groups. The control group, which received standard nursing care. The data of control patients who were not receiving physiotherapy were obtained from the hospital records. The intervention group was prospectively taken into the chest physiotherapy program. This study was conducted on sample of 30 patients in the ICU in alaassad university hospital. Demographics, diagnostic profiles, co-existing chronic diseases, respiratory parameters on admission, patient’s overall severity by Acute Physiology and Chronic Health Evaluation II score, patient outcome, duration of stay in ICU, duration of ventilator support, and complications were assessed. The extubation time and length of ICU stay were compared between the two groups. Control patients had a longer period of ventilator dependency than the intervention patients and this difference was statistically significant (P < 0.05). It was noted that the resulting length of stay in the ICU was significantly lower in the intervention group than in the control group (P < 0.05). Although the patients had similar diagnoses and physical features, the length of stay in the ICU was significantly lower in the intervention group. The results show that physiotherapy has a great impact on ventilatory dependency and length of stay in the ICU
References used
STILLER K. Physiotherapy in intensive care. Chest (2012) 118:1801–1813
BUHOP KL. Pulmonary rehabilitation in the intensive care unit. In: Fishman AP, editor. Pulmonary rehabilitation. New York: Marcel & Dekker. (1996) 725–738
KENDALL L, Jockson SE. Intensive Therapy–Physiotherapy Management of the Adult Patient. In: Paticia A, Downie FC, editors. Cash’s text book of chest, heart and vascular disorder for physiotherapist. Philadelphia: JB Lippincot. (1987) 249–254
CIESTA ND. Chest physical therapy for patients in the intensive care unit. Phys Therap (1996) 76:609–625
BAWTON DL. Nosocomial pneumonia in the ICU: year 2000 and beyond. Chest (1999) 115:285–335
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care policy on dysphagia in neurological system patients in critical care u
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and method: the study was conducted on 40 patients divided on four groups (Shaker
Exercise, Mendelsohn maneuver, [Shaker Exercise, and Mendelsohn maneuver] and
control group) in critical care units in the Assad university hospital and the National
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and Mendelsohn maneuver together were the most effective in reduce dysphagia levels and
recommended about importance of Shaker Exercise, and Mendelsohn maneuver for
patients with dysphagia.
Recovery from cardiac surgery is associated with severe chest pain at the site of sternotomy and limb pain at the site of conduit harvesting. Patients routinely report mild to moderate pain even though they were administered sedative drugs. The integ
ration of massage therapy into the team approach in patient care constitutes a move forward that recognizes pain as the fifth vital sign after pulse, blood pressure, temperature, and respiratory rate.
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Our findings demonstrate that the mean score of pain severity in both groups was not significantly different at the beginning of the study. This means that pain severity was similar in both groups at the beginning of the study before applying any intervention. Results showed that there was a significant difference between the mean score of pain severity of the intervention group and the control group, after applying hand and foot massage together. The study concludes that foot and hand massage is one of the available interventions in complementary medicine and treatment which provides an opportunity for nurses to care for their patients.
Patients in the intensive care unit (ICU), especially ventilated patients, are
at considerable risk of developing ocular surface disease because the protective eye
mechanisms are damage, as decrease eyelid closure ,unable blinking, decreased produc
ing
tears, increased expose the eye to pathogen bacteria . These factors often result in incomplete
lid closure and expose and decay the eye, and this called the exposure keratopathy, which
appear that high rate with ventilated patients.
The eye care is a part of the providing care to every patient in critical care units.
Whereas the Unconscious and Sedation and paralysis patients are the most serious group and
the most need to the eye care for maintain the eye in a state of normal.objective:To determine
the effect kind of eye care policy on incidence rate of exposure keratopathyamong
mechanically ventilated patients.
Background :In spite of all the advances in health care and medical technology, provision of qualified health care to cancer patients remains one of the major challenges that health care professionals have to face in the next years. this study was co
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represent the work environment that nurses work within. Nursing work environ
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received an international attention recentlyspecial emphasis on the importance of
improvinghospitals environment for its influence on organizational and individuals
outcomes such as absence of nurses, job dissatisfaction, nursing turnover , Burnout
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essential element in the system of health care, work in the pressing environment can affect
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the study 2,where the highest scoring of subscale was:/nurse physician communications
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the study showed the existence of a direct relationship between the work environment
unfavorable and burnout , and the work environment in all its dimensions affect the
burnout, where after /nurse manager's ability, leadership, and support of nurses/ where the
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skills/ the less influential dimensions in the development of nurse’ burnout, on , study
showed that there is a link between each of the dimensions of the an environment nursing
work and dimensions of the burnout, where that the / nurse foundations for quality of care/
importance of its role more than the impact in raising the rate of emotional exhaustion,
while after /nurse participation in organization affairs/ of the importance of its role more
than the dimensions of the work environment impact in raising the rate of
depersonalization, as it was after the / adequacy of resources and nurses/ more than the
dimensions of the work environment impact in reducing the proportion of personal
achievement.
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