Evaluation of the Effect of Pulmonary Rehabilitation on Patients With High Flow Oxygen Therapy

Objective: the purpose of this study was to evaluate the effect of lung rehabilitation on patients treated with high flow humidification apparatus in ICU. Methods: 70 patients in ICU who were treated with high flow humidification apparatus from June 2019 to June 2020 were randomly divided into two groups. The experimental group was treated with pulmonary rehabilitation and the control group was treated with routine medical treatment only. All patients were evaluated and measured by bedside diaphragm ultrasound. The vital signs of all patients were monitored every day. MRCsum assessment of peripheral muscle strength, 30s sitting test, modified Barthel index, Borg dyspnea score, arterial blood gas analysis and bedside diaphragm ultrasound monitoring were performed at admission and discharge. Finally, statistics were made on the use of non-invasive ventilator, endotracheal intubation, new complications (pressure sore, aspiration, thrombus, etc.) and the time of patients getting out of bed for the first time.The end point of the experiment was 28 days.

Comprehensive interventions based on comprehensive evaluation and customization of patients, including, but not limited to, exercise training, education and behavioral changes, aimed at improving the physiological and psychological status of patients with chronic respiratory diseases, and urge patients to adhere to health promotion activities for a long time.

Medical Research Council,Muscle strength assessment,total points0~60，less than 48scores means ICU aquired weaknesses.

Number of sit-to-stand test in 30s,Muscle endurance assessment,The more times, has the better muscular endurance.

barthel index,Daily activity assessment,Assessment of activities of daily living.total points0~100，less than 60 scores means can't independent living.

arterial partial pressure of oxygen,Partial pressure of oxygen in arterial blood,normal range is 80~100.

The thickness of the diaphragm during inhalation,The thickness of diaphragm at the end of expiratory is about 0.25cm.

The thickness of the diaphragm during exhalation,The thickness of diaphragm at the end of expiratory is about 0.15cm.

Rate of diaphragmatic thickness change during breathing,Diaphragmatic dysfunction is considered less than 20%.

Intubation,Whether endotracheal intubation was performed for invasive mechanical ventilation within 28 days

Inclusion Criteria: The age is ≥ 18 years old; the hemodynamics is stable; 50 < heart rate < 120 beats / min ; 90 < systolic blood pressure < 200mmHg ; 55 < mean arterial pressure < 120mmHg; do not increase the dose of pressor drugs for at least 2 hours; intracranial pressure is stable and there are no seizures within 24 hours; the respiratory state is stable; the patient's finger pulse oxygen saturation ≥ 88%; 10 < respiratory frequency < 35 beats / min. Exclusion Criteria: Pregnancy; acute cardio-cerebrovascular events; spinal or limb fractures; active bleeding.