دورية أكاديمية
Acute Effects of Sitting Out of Bed and Exercise on Lung Aeration and Oxygenation in Critically Ill Subjects.
| العنوان: | Acute Effects of Sitting Out of Bed and Exercise on Lung Aeration and Oxygenation in Critically Ill Subjects. |
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| المؤلفون: | Hickmann, Cheryl, Montecinos-Munoz, Natalia, Castanares Zapatero, Diego, Arriagada-Garrido, Ricardo, Jeria-Blanco, Ursula, Gizzatullin, Timour, Roeseler, Jean, Dugernier, Jonathan, Wittebole, Xavier, Laterre, Pierre-François |
| المساهمون: | UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service de soins intensifs, UCL - (SLuc) Service de médecine physique et de réadaptation motrice, UCL - (SLuc) Service d'anesthésiologie |
| المصدر: | Respiratory care, Vol. 66, no. 2, p. 253-262 (2021) |
| بيانات النشر: | Daedalus Enterprises for the American Association for Respiratory Therapy |
| سنة النشر: | 2021 |
| المجموعة: | DIAL@USL-B (Université Saint-Louis, Bruxelles) |
| مصطلحات موضوعية: | Alveolar recruitment, Critically ill, Early mobilization, Electrical impedance tomography, Exercise therapy, Oxygenation |
| الوصف: | BACKGROUND: Early mobilization during critical illness is safe and has beneficial effects on functional outcomes. However, its impact on pulmonary function has not been thoroughly explored. We hypothesized that a sitting position out of bed coupled with exercise could result in an improvement in oxygenation and lung aeration. METHODS: The study was conducted on a cohort of adult subjects within a week of their admission to an ICU. Subjects were transferred to a chair and undertook a 15-min session of exercise, either active or passive. Subjects in the control group were only transferred to a chair. Electrical impedance tomography, a reliable bedside technique monitoring regional lung aeration and the distribution of ventilation, was continuously performed, and blood gases were assessed at baseline and 20 min post-exercise. RESULTS: The cohort included 40 subjects, 17 of whom were mechanically ventilated and 23 spontaneously breathing. The control group for each modality consisted of 5 mechanically ventilated or 5 spontaneously breathing subjects. Mild hypoxemia was present in 45% of the spontaneously breathing cohort, whereas the mechanically ventilated subjects demonstrated moderate (50%) or severe (12%) hypoxemia. Compared with the control group, early mobilization induced a significant increase in lung aeration. In mechanically ventilated subjects, lung aeration increased, especially in the anterior lung regions (mean impedance [95% CI]: T1 (baseline in bed) = 1,265 [691-1,839], T2 (chair sitting) = 2,003 [1,042-2,963], T3 (exercise) = 1,619 [810 2,427], T4 (post exercise in chair) = 2,320 [1,186-3,455]). In spontaneously breathing subjects, lung aeration increased mainly in the posterior lung regions (mean impedance [95% CI]: T1 = 380 [124-637], T2 = 655 [226-1,084], T3 = 621 [335-906], T4 = 600 [340-860]). P aO2 /F IO2 increased, especially in subjects with lower P aO2 /F IO2 at baseline (< 200) (133 ± 31 to 158 ± 48, P = .041). CONCLUSIONS: For critically ill subjects, a sitting position and exercise ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 0020-1324 1943-3654 |
| العلاقة: | boreal:242223; http://hdl.handle.net/2078.1/242223Test; info:pmid/32994357; urn:ISSN:0020-1324; urn:EISSN:1943-3654 |
| DOI: | 10.4187/respcare.07487 |
| الإتاحة: | https://doi.org/10.4187/respcare.07487Test http://hdl.handle.net/2078.1/242223Test |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.B80EE303 |
| قاعدة البيانات: | BASE |
| تدمد: | 00201324 19433654 |
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| DOI: | 10.4187/respcare.07487 |