Analysis of the intervention effects of comfortable minimal sedation combined with graded early activity on intensive care unit-acquired weakness in elderly patients undergoing mechanical ventilation
Objective To explore the therapeutic effects of comfortable minimal sedation combined with graded early ac-tivity on intensive care unit-acquired weakness(ICU-AW)in elderly patients undergoing mechanical ventilation.Methods 168 patients who were admitted to intensive care unit(ICU)of Minhang Hospital Affiliated to Fudan University and received me-chanical ventilation therapy from January 2022 to December 2022 were randomly divided into observation group(n=84)and control group(n=84).The control group received routine rehabilitation sedation plan in ICU,and the observation group re-ceived comfortable minimal sedation combined with graded early activity.The scores of Richmond Agitation-Sedation Scale(RASS),Medical Research Council Muscle Strength(MRC)and Activities of Daily Living(ADL)were compared between the two groups at 1,3,5 and 7 days after admission to ICU.The dosage of sedative drugs,duration of mechanical ventilation and ICU stay time were compared between the two groups.Results Compared with the control group,the observation group used significantly less propofol and had shorter duration of mechanical ventilation and ICU stay time,with statistically signifi-cant differences(P＜0.05).There was an interaction between the time distribution and grouping of the scores of MRC(F=36.087,P＜0.01)and ADL(F=14.201,P＜0.01)in both groups.Compared with the first day after admission to ICU,the scores of MRC and ADL of the two groups at day 3,5 and 7 after admission to ICU increased,with statistical significance(P＜0.001).On day 7 after admission to ICU,there was a statistically significant difference in the composition ratio of ICU-AW patients between the two groups(26.19％vs 65.29％,P=0.013).Conclusion The combination of comfortable mini-mal sedation and graded early activity may help reduce the incidence of ICU-AW in elderly ICU patients and improve their prognosis.
elderlycomfortable minimal sedationmechanical ventilationintensive care unit-acquired weakness
万方数据
维普
