[Effect of rehabilitation initiation timing in the intensive care unit on outcomes in patients with pneumonia].

Autor:	Andreychenko SA; Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency, Moscow, Russia., Bychinin MV; Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency, Moscow, Russia., Clypa TV; Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency, Moscow, Russia., Yeremenko AA; Russian Scientific Center for Surgery named after Academician B.V. Petrovsky, Moscow, Russia.
Jazyk:	ruština
Zdroj:	Voprosy kurortologii, fizioterapii, i lechebnoi fizicheskoi kultury [Vopr Kurortol Fizioter Lech Fiz Kult] 2021; Vol. 98 (6. Vyp. 2), pp. 11-16.
DOI:	10.17116/kurort20219806211
Abstrakt:	Early rehabilitation in the intensive care unit is a promising component of post-intensive care syndrome (PICS) treatment and prevention. However, the optimal time to start mobilizing critically ill patients is still to be determined. Objective: To evaluate the effect of rehabilitation initiation timing on outcomes in patients with pneumonia. Material and Methods: The study included 106 patients with pneumonia (27 patients with community-acquired pneumonia and 79 patients with early-onset healthcare associated pneumonia) who received daily rehabilitation treatment for at least 7 days in the intensive care unit. All patients were retrospectively assigned to the early rehabilitation (ER) group if rehabilitation treatment was started within the first 48 hours of admission to the intensive care unit or the delayed rehabilitation (DR) group if mobilization was not initiated within this time frame. Results: The baseline clinical and demographic characteristics of the patients did not differ between the groups. During rehabilitation, rates of catecholamine use and the psychiatric signs of PICS frequency were also comparable. The duration of mechanical ventilation was 1.5 times shorter in ER group patients than in DR group (8 vs. 6 days and 13 vs. 9 days, respectively; p =0.003). The ICU and hospital stay were also significantly shorter in ER group compared with the DR group (12 (9-16) vs. 19 (13-30), respectively; p <0.001; 23 (12) vs. 31 (13) as inpatients, respectively; p =0.005). Mortality and severe complications rate were comparable between the groups. Conclusions: The earliest possible start of rehabilitation provided the patient's condition is stable, can reduce the duration of respiratory support and hospital stay for patients with pneumonia.
Databáze:	MEDLINE
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