The Effect of High Protein and Mobility-Based Rehabilitation on Clinical Outcomes in Survivors of Critical Illness

被引：4

作者：

Wappel, Stephanie ^{[1
]}

Tran, Dena H. ^{[2
]}

Wells, Chris L. ^{[3
]}

Verceles, Avelino C. ^{[4
]}

机构：

[1] Greater Baltimore Med Ctr, Dept Pulm Crit Care & Sleep Med, Towson, MD USA

[2] Univ Maryland, Med Ctr, Dept Med, Midtown Campus, Baltimore, MD 21201 USA

[3] Univ Maryland, Med Ctr, Dept Phys Therapy, Baltimore, MD 21201 USA

[4] Univ Maryland, Sch Med, Div Pulm & Crit Care Med, Baltimore, MD 21201 USA

来源：

RESPIRATORY CARE | 2021年 / 66卷 / 01期

关键词：

rehabilitation; nutrition therapy; mechanical ventilation; weaning; critical illness; patient discharge; NUTRITION SUPPORT; ILL PATIENTS; GUIDELINES; MORTALITY; WEAKNESS;

D O I：

10.4187/respcare.07840

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

BACKGROUND: Protein supplementation and mobility-based rehabilitation programs (MRP) individually improve functional outcomes in survivors of critical illness. We hypothesized that combining MRP therapy with high protein supplementation is associated with greater weaning success from prolonged mechanical ventilation (PMV) and increased discharge home in this population. METHODS: We conducted a retrospective analysis assessing the effects of an MRP on a cohort of survivors of critical illness. All received usual care (UC) rehabilitation. The MRP group received 3 additional MRP sessions each week for a maximum of 8 weeks. Subjects were prescribed nutrition and classified as receiving high protein (HPRO) or low protein (LPRO), based on a recommended 1.0 g/kg/d, and then the subjects were categorized into 4 groups: MRP+HPRO, MRP+LPRO, UC+HPRO, and UC+LPRO. RESULTS: A total of 32 subjects were enrolled. The MRP+HPRO group had greater weaning success (90% vs 38%, P = .045) and a higher rate of discharge home (70% vs 13%, P = .037) compared to UC+LPRO group. The MRP+HPRO group had a higher, nonsignificant rate of discharge home compared to the MRP+LPRO (70% vs 20%, P = .10). CONCLUSIONS: Combining high protein with mobility-based rehabilitation was associated with increased rates of discharge home and ventilator weaning success in survivors of critical illness. Further studies are needed to evaluate the role of combined exercise and nutrition interventions in this population.

引用

页码：73 / 78

页数：6