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| Application Effect of Evidence-Based Specialist Nurse Guidance on Early Respiratory Muscle Training in Patients with Mechanical Ventilation in ICU |
| LIU Cuicui, XING Huanmin, ZHAO Shanshan, et al |
| Department of Critical Care Medicine, Henan Provincial People's Hospital, Zhengzhou Henan 450003 |
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Abstract 【Objective】To investigate the application effect of evidence-based specialist nurse guidance on early respiratory muscle training in patients with mechanical ventilation in intensive care unit (ICU). 【Methods】A total of 160 patients with mechanical ventilation in ICU who were treated in Henan Provincial People's Hospital from April 2023 to June 2024 were selected. Among them, 80 patients with mechanical ventilation in ICU who underwent routine rehabilitation training from April 2023 to October 2023 were included in Group B. From February 2024 to June 2024, 80 patients with mechanical ventilation in ICU who implemented early respiratory muscle training under the guidance of evidence-based specialist nurses were included in group A. The recovery status, respiratory muscle function [maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP)], grip strength, muscle strength classification score, disease severity, the occurrence of adverse events, and mechanical ventilation withdrawal were compared in the two groups.【Results】The mechanical ventilation time, ICU stay and total hospital stay in group A were shorter than those in group B (P<0.05). After the intervention, MEP, MIP, grip strength and MRC muscle strength rating in group A were higher than those in group B (P<0.05), acute physiological and chronic health status Ⅱ (APACHEⅡ) scores were lower than those in group B (P<0.05). The incidence of acquired asthenia, respiratory related pneumonia and delirium in ICU in group A was lower than that in group B, and the success rate of mechanical ventilation withdrawal was higher than that in group B (P<0.05). 【Conclusion】Early respiratory muscle training guided by evidence-based specialist nurses can improve the respiratory muscle function, enhance the muscle strength of patients with mechanical ventilation in ICU, reduce the risk of adverse events of mechanical ventilation, and promote the recovery of patients.
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Received: 21 January 2025
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[1] NIU E, YE C Z, ZHAO W Y, et al. Coat protein of Chinese wheat mosaic virus upregulates and interacts with cytosolic glyceraldehyde-3-phosphate dehydrogenase, a negative regulator of plant autophagy, to promote virus infection[J].J Integr Plant Biol,2022,64(8):1631-1645.
[2] LEHMKUHL L, DREYER P, LAERKNER E, et al. Mobilisation during mechanical ventilation: A qualitative study exploring the practice of conscious patients, nurses and physiotherapists in intensive care unit[J].J Clin Nurs,2024,33(4):1493-1505.
[3] SILVA D O, CRUZ I C D .Nursing evidence-based inteprofissional practice guidelines for response to mechanical ventilation:adult in ICU systematic literature review[J].J Special Nurs Care,2020,12(6):305-307.
[4] BAGADE A A, JIANDANI M P, MEHTA A. Medical research council dyspnoea score and forced expiratory volume in one second as the predictors of vertical climbing in chronic obstructive pulmonary disease patients[J].Int J Med Sci,2017,5(4):1558.
[5] 吴弦光,陈迪,荀芳,等.发展康复事业促进实现“健康中国2030”目标[J].中国康复理论与实践,2022,28(1):6-14.
[6] YAO H M, ZHANG J, JIANG R, et al. Early predictive value of ultrasound measurements of rectus femoris cross-sectional area to diagnose ICU-acquired weakness in patients undergoing invasive mechanical ventilation: a prospective cohort study[J].Eur J Med Res,2024,29(1):379.
[7] 魏大琼,龙春花,吴丝丝,等.急性心肌梗死患者早期运动康复的循证护理实践[J].护理学报,2023,30(11):53-58.
[8] 尹佳宁,管晓敏,贾登帅,等.ICU机械通气患者撤机后呼吸肌训练的最佳证据总结[J].中华护理杂志,2024,59(1):33-41.
[9] 王彩虹,秦君玫,贲艳丽.早期康复训练对机械通气患者ICU获得性肌无力的改善效果[J].中国护理管理,2019,19(3):457-461.
[10] 马晶,曹梅,张晓燕,等.呼吸肌训练用于重症监护病房机械通气获得性肌无力患者的临床观察[J].中华保健医学杂志,2023,25(3):261-264.
[11] 冯月梅,孙乔,关纯,等.早期肺康复训练对ICU急性呼吸窘迫综合征有创机械通气患者脱机后预后的影响研究[J].中华危重病急救医学,2024,36(3):286-292.
[12] 成晶,梁敏,陈琼,等.渐进式早期活动方案在ICU机械通气患者中的应用[J].中国护理管理,2024,24(10):1481-1486. |
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2025, Vol. 42 
