【論文摘要】The Effect of Rehabilitation Program on Long-Term Respirator-Dependent Patients

【論文摘要】長期呼吸器依賴病人介入呼吸肌訓練之成效分析

陳妙玉(Miao-Yu Chen) ； 黃柏豪(Po-Hao Huang) ； 黃惠鈴(Hui-Lin Huang) ； 周偉倪(Willy Chou)

《呼吸治療》 20卷2期 (2021/07) Pp. 76-76

https://doi.org/10.6269/JRT.202107_20(2).0020

摘要

Objective: The purpose of our study was to evaluate the improvement in prognosis of patients with chronic respiratory failure via undergoing progressive and planned respiratory muscle strength training. Methods: In this retrospective study, we collected 22 respiratory failure patients who were under respirator treatment from October 2017 to September 2018 at a local teaching hospital in southern Taiwan. They were assessed by the chest specialty and considered as stable medical condition before rehabilitation programs. And 13 people in study group and 9 patients in control group. Six weeks daily pulmonary rehabilitation programs include upper limbs' range of motion, chest mobility, and mainly 30 minutes progressive sand-bag on upper abdomen for diaphragmatic resistant exercise with adjusted best pressure support level of respirator to maintain 8 ml/Kg tidal volume. Results:The study group has better Glasgow coma scale(10.3 ± 2.2 vs 6.9 ± 1.6; p=0.005), lower respirator pressure support (14.6 ± 2.2 vs 17.6 ± 2.2 cmH2O; p=0.006) than control group before rehabilitation programs(Table1). After 6 weeks' pulmonary programs, the study group has better improvement in respirator pressure support (9.7 ± 1.8 vs. 16.2 ± 7.2 cmH2O; p = 0.005), tidal volume change(68.1 ± 66.8 vs.-14 ± 94.6 ml; p = 0.048) and rapid shallow breathing index change(-47.6 ± 36.7 v. S 1.17 ± 47.6; p=0.028). 5patient(71.4%)in study group and 2 patients(28.6%) in control group had achieved successful weaning from respirators. Although there is no statistical difference between the maximum inspiratory pressure and maximum expiratory pressure between the two groups, the study group shows a positive correlation with time trend, while the control group shows a negative correlation with time trend. Conclusion: Long-term respirator-dependence patients will improve their respirator pressure support, tidal volume, and rapid shallow breathing index through appropriate lung rehabilitation programs, leading to better weaning rate. To stable medical condition respirator using patients, structural pulmonary rehabilitation is a must to enhance their motor function and life quality.

關鍵字

Long-term respirator-dependent ； Rehabilitation programs ； Rapid shallow