The Implementation of Early Mobilization and Chest Physiotherapy on Weaning Rate of Prolong Weaning Patients.

NCT06095609 | Completed

• 1 other identifier: TYGH111002
• Study Type: interventional
• Target: 202
• Locations: 1 country
• Sites: 1

Brief Summary

Weaning from mechanical ventilator is essential to liberate patients to normal life. Prolong weaning is defined as failure of 3 times spontaneous breath trial (SBT) and requiring more than 7 days weaning from mechanical ventilation after first SBT. higher unsuccessful rate of extubation and higher mortality rate. Possible reasons to cause prolong weaning could be attributed to intensive care unit acquired weakness (ICU-AW) and poor lung hygiene. In order to solve these two problems and increase the weaning rate, early mobilization (EM) and chest physiotherapy (CPT) are considered as possible strategy to attain the goal. According to previous articles, lacking of control group and small sample size made it difficult to confirm the true effect of EM and CPT on prolong weaning patients. Thus, the aims of this articles are discussing the influence from EM with CPT on weaning rate and other hospitalization outcomes with larger sample sizes and control group.

Conditions

Prolonged Weaning, Early Mobilization, Chest Physiotherapy

Outcome Measures

Primary Outcomes (1)

• Weaning success rate

  Weaning success was defined as patients being free from MV or BiPAP for 5 days based on Taiwan

  up to 6 weeks in respiratory care center

Secondary Outcomes (6)

• RCC mortality rate

  up to 6 weeks in respiratory care center

• hospital mortality rate

  up to 6 weeks in respiratory care center

• discharge to home rate

  after 6 weeks in respiratory care center

• total mechanical ventilator use

  up to 6 weeks in respiratory care center

• RCC days of stay

  up to 6 weeks in respiratory care center

Study Arms (2)

Early mobilization plus chest physiotherapy

EXPERIMENTAL

Physiotherapy program comprised two parts early mobilization and CPT. They could be divided into different levels depended on patients' ability. In terms of the levels of early mobilization, first level was defined as patients who could only receive passive patterns of exercise. Second level would be executed to patient who could only take exercise on the bed or with back support. Third level would be implemented when patients could advance to receive physiotherapy beside the bed without support. The eventual level would be conducted when patients was able to leave beds by their own. In line with chest physiotherapy, level I was defined as patients who could only receive passive lung hygiene protocol. Level II would be executed when patient can control their breath and cough by their own. Level III would be implemented when patient can maintain their body steadily and finish the chest physiotherapy protocol.

Other: Early mobilization plus chest physiotherapy

Routine care

NO INTERVENTION

no physiotherapy involved

Interventions

Early mobilization plus chest physiotherapy OTHER

Early mobilization:early mobilization has been confirmed its positive effectiveness on cutting down the MV use days and mortality rate, attenuating the side effect such as muscle strength loss and functional activity dysfunction resulting from ICU acquired weakness among the patients with mechanical ventilation. Chest physiotherapy:a common technique to reduce the respiratory complications in ICU, has been proved certain positive influence on airway clearance and hospital lengths of stay.

Early mobilization plus chest physiotherapy

Eligibility Criteria

• Age: 20 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

Sponsors & Collaborators

• Taoyuan General Hospital: lead

Study Sites (1)

Taoyaun General Hospital, Ministry of Wealth and Health

Taoyuan District, Taoyuan Dist., 330, Taiwan

Location

MeSH Terms

Interventions

Early Ambulation

Intervention Hierarchy (Ancestors)

Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR

Model Details: The study retrospectively reviewed the medical record from the medical team. Patients before 2019/01/01 who didn't receive physiotherapy are regarded as control group. Patients after 2019/01/01 are assigned to the experiment group.

Study Record Dates

• First Submitted: June 20, 2022
• First Posted: October 23, 2023
• Study Start: June 1, 2022
• Primary Completion: June 18, 2022
• Study Completion: June 19, 2022
• Last Updated: October 23, 2023

Record last verified: 2022-09

Locations

TW (1)