Effect of cough assist device on blood gasses and period of mechanical ventilator for pneumonic children with general hypotonia

Abstract Background Cough assist devices play an important role with patients in the intensive care unit (ICU), particularly those with neuromuscular diseases which had abnormal muscle tone. It was previously thought to be the main technique for improving cough efficacy, which aids in weaning from mechanical ventilation and improves patient outcomes. So, we selected randomly the odd numbers from Abo El-Reesh hospital records, and 30 children of both sexes with pneumonia were selected, aged from 6 months to 3 years, who were selected from intensive care unit: fifteen children were the control group, who received the selected physical therapy program (postural drainage, percussion and resist diaphragm), and another fifteen children were the study group, who received previous physical therapy program, which was selected, and cough assist device. Results This study revealed the effect of cough assist device on blood gasses and the period of mechanical ventilator on children with pneumonia and general hypotonia. There was a significant decrease in pH, PaCO2, and HCO3 post treatment compared with that pretreatment in the study and control groups (p < 0.05). The percentage of decrease in pH, PaCO2, and HCO3 in study group A were 0.4, 38.26, and 30.28% respectively while that in the control group were 0.4, 32.56, and 25.48% for pH, PaCO2, and HCO3 respectively. There was a significant increase in PaO2 post treatment compared with that pretreatment in the study and control groups (p < 0.001). The percentage of increase in PaO2 in the study group was 32.13% and that in control group was 30.09%. There was no significant difference in pH, PaCO2, and HCO3 between both groups pre-treatment (p ˃ 0.05). Also, there was no significant difference between groups post treatment (p ˃ 0.05). The median (IQR) period of mechanical ventilation in the study group was 5 (7, 4) days while that in control group was 8 (18, 5) days. There was a significant decrease in period of mechanical ventilator of the study group compared with that of control group (p = 0.03). Conclusion The cough assist device and physical therapy program were selected for children in the intensive care unit which have the same effect on arterial blood gasses as they optimize pH, PO2, PCO2, and HCO3, but the cough assist device helps in accelerating weaning of mechanical ventilator so as decrease the period of mechanical ventilator.

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Functional Stretching Exercise Submitted for Spastic Diplegic Children: A Randomized Control Study

Rehabilitation Research and Practice ◽

10.1155/2014/814279 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Mohamed Ali Elshafey ◽

Adel Abd-Elaziem ◽

Rana Elmarzouki Gouda

Keyword(s):

Physical Therapy ◽

Control Group ◽

Study Group ◽

Therapy Program ◽

Passive Stretching ◽

Gait Parameters ◽

Before And After ◽

Physical Therapy Program ◽

Control Study ◽

Stretching Exercises

Objective.Studying the effect of the functional stretching exercise in diplegic children.Design.Children were randomly assigned into two matched groups.Setting.Outpatient Clinic of the Faculty of Physical Therapy, Cairo University.Participants.Thirty ambulant spastic diplegic children, ranging in age from five to eight years, participated in this study.Interventions.The control group received physical therapy program with traditional passive stretching exercises. The study group received physical therapy program with functional stretching exercises. The treatment was performed for two hours per session, three times weekly for three successive months.Main Outcome Measure(s).H∖M ratio, popliteal angle, and gait parameters were evaluated for both groups before and after treatment.Results.There was significant improvement in all the measuring variables for both groups in favor of study group. H∖M ratio was reduced, popliteal angle was increased, and gait was improved.Conclusion(s).Functional stretching exercises were effectively used in rehabilitation of spastic diplegic children; it reduced H∖M ratio, increased popliteal angle, and improved gait.

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Efficacy of ankle kinesiotape on balance in children with spastic diplegia

Bulletin of Faculty of Physical Therapy ◽

10.1186/s43161-020-00015-7 ◽

2020 ◽

Vol 25 (1) ◽

Author(s):

Samar Sami Ibrahim ◽

Emam Hassan EL-Negmy ◽

Amina Salem Hindawii ◽

Nahla M. Ibrahim

Keyword(s):

Physical Therapy ◽

Postural Stability ◽

Stability Index ◽

Control Group ◽

Spastic Diplegia ◽

Study Group ◽

Therapy Program ◽

Before And After ◽

Physical Therapy Program ◽

Ankle Dorsiflexor

Abstract Background Adequate and efficient standing postural balance is key for functional walking and handling abilities in children with spastic diplegia. This study was designed to evaluate the effect of kinesiotape applied on ankle dorsiflexor muscles on balance in children with spastic diplegia. Thirty children with spastic diplegia of both genders participated in the study: 16 boys and 14 girls between 4 and 10 years old. They were divided randomly and equally into two groups: a control group, in which children received the standard physical therapy program for children with diplegia; and the study group, who received the same physical therapy program as in the control group but after kinesiotape application over the ankle dorsiflexor muscles. Both groups received the treatment program for 1 h, three times per week, for three successive months. Postural stability was assessed through evaluation of three stability index (anteroposterior, mediolateral, and overall) for all children by the Biodex Balance System before and after treatment. Results Statistical analysis of results before and after treatment was performed by mixed MANOVA to compare effects both within and between groups on stability indexes, and post hoc tests were carried out for subsequent multiple comparison. The level of significance for all statistical tests was set at p < 0.05. Before treatment, there was no significant difference in the stability index between both groups (p > 0.05). Comparison between both groups post-treatment revealed a significant decrease in the measured variables of the study group compared with that of the control group (p < 0.05). Conclusion Adding ankle kinesiotaping over dorsiflexor muscles in conjunction with a balance and gait training exercise program for children with diplegia can enhance postural stability and decrease sway. This study suggests that it should be added to the treatment program for children with diplegia. Trial registration This study was registered retroactively. Identifier: NCT04243928

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Effects of COVID-19 pandemic on breastfeeding rates in a neonatal intensive care unit

Journal of Perinatal Medicine ◽

10.1515/jpm-2020-0462 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Asli Okbay Gunes ◽

Emre Dincer ◽

Nilgun Karadag ◽

Sevilay Topcuoglu ◽

Guner Karatekin

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Breast Milk ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Control Group ◽

Study Group ◽

Intake Rate ◽

Informed Consent Form ◽

Group 2

Abstract Objectives To find out if the expressed breast milk delivery rate to neonatal intensive care unit (NICU) for babies who were hospitalized for any reason other than COVID-19, and exclusive breastfeeding (EB) rates between discharge date and 30th day of life of those babies were affected by COVID-19 pandemic. Methods Babies who were hospitalized before the date first coronavirus case was detected in our country were included as control group (CG). The study group was divided into two groups; study group 1 (SG1): the mothers whose babies were hospitalized in the period when mother were asked not to bring breast milk to NICU, study group 2 (SG2): the mothers whose babies were hospitalized after the date we started to use the informed consent form for feeding options. The breast milk delivery rates to NICU during hospitalization and EB rates between discharge and 30th day of life were compared between groups. Results Among 154 mother-baby dyads (CG, n=50; SG1, n=46; SG2, n=58), the percentage of breast milk delivery to NICU was 100%, 79% for CG, SG2, respectively (p<0.001). The EB rate between discharge and 30th day of life did not change between groups (CG:90%, SG1:89%, SG2:75.9; p=0.075). Conclusions If the mothers are informed about the importance of breast milk, the EB rates are not affected by the COVID-19 pandemic in short term, even if the mothers are obligatorily separated from their babies. The breast milk intake rate of the babies was lowest while our NICU protocol was uncertain, and after we prepared a protocol this rate increased.

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Changes in the mobility of obese people under the influence of a physical therapy program

Health, sport, rehabilitation ◽

10.34142/hsr.2019.05.03.01 ◽

2019 ◽

Vol 5 (3) ◽

pp. 9 ◽

Cited By ~ 1

Author(s):

M.G. Aravitska

Keyword(s):

Physical Therapy ◽

Rehabilitation Program ◽

Control Group ◽

Functional Movement Screen ◽

Obese Patients ◽

Functional Movement ◽

Therapy Program ◽

Physical Therapy Program ◽

One Year ◽

High Level

Objective: to determine the effectiveness of a physical therapy program for patients with obesity by the indicators of Functional Movement Screen test exercises.Materials and methods. A total of 114 people of the second adulthood with alimentary-constitutional obesity of the I-III degrees were examined. They were divided according to the level of compliance into two groups. The comparison group consisted of individuals with a low level of compliance; they did not go through a rehabilitation program, but were informed about the risks of obesity; acquainted with the basic principles of hypocaloric nutrition and physical activity. The main group consisted of individuals with a high level of compliance; they underwent a developed program for correcting body weight using measures to maintain a high level of compliance, nutrition modification, increased physical activity, lymphatic drainage procedures, and elements of behavioral psychocorrection. The control group consisted of 60 people with no signs of obesity. A survey of the test exercises Functional Movement Screen was conducted in dynamics before and after the one-year period of implementation of the rehabilitation program.Results. During the initial examination in obese patients, all the obtained parameters of the Functional Movement Screen exercises were statistically significantly worse than in individuals with normal body weight (p <0.05). Re-examination of patients with low compliance showed that no statistically significant positive changes occurred in any test test (p> 0.05). When analyzing the results of test exercises of patients with a high level of compliance under the influence of a physical therapy program, a statistically significant improvement was achieved in all studied parameters relative to the initial level (p <0.05).Conclusions: Diagnostics of mobility based on test exercises Functional Movement Screen in physical therapy programs for obese patients is a modern, simple and affordable method of rehabilitation examination. To achieve the target level of the control group for the studied parameters by patients of II-III degree of obesity, the rehabilitation program should be long for one year.

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Abstract TP329: Early Initiation of Oral Antihypertensives Reduces Intensive Care Unit Stay and Hospital Cost in Patients With Hypertensive Intracerebral Hemorrhage

Stroke ◽

10.1161/str.51.suppl_1.tp329 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Zhu Zhu ◽

Matthew Bower ◽

Sara Stern-Nezer ◽

Steven Atallah ◽

Dana Stradling ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Intracerebral Hemorrhage ◽

Resource Utilization ◽

Hospital Cost ◽

Early Initiation ◽

Control Group ◽

Study Group ◽

Significant Difference ◽

Hypertensive Intracerebral Hemorrhage

Background and Purpose: Intravenous nicardipine infusion is effective for intensive blood pressure (BP) control in patients with hypertensive intracerebral hemorrhage (ICH). However, its use requires close hemodynamic monitoring in the intensive care unit (ICU). Prompt transition from nicardipine infusion to oral antihypertensives may reduce ICU length of stay (LOS). This study aimed to examine the effect of early verse late initiation of oral antihypertensives on hospital resource utilization in patients with hypertensive ICH. Methods: This is a retrospective study of patients with hypertensive ICH and initial systolic BP ≥ 180 mmHg from January 1, 2013 to December 31, 2017. Only patients who received nicardipine infusion were included. Based on timing of receiving oral antihypertensives within or after 24 hours of emergency department arrival, patients were divided into study or control group, respectively. Baseline characteristics, duration of nicardipine infusion, ICU and hospital LOS, functional outcome at hospital discharge, and the cost were compared between the 2 groups using univariate and multivariate analysis to adjust for dependent variables. Results: A total of 166 patients (90 in study group, 76 in control group) were identified. There was no significant difference in demographic features, past medical history or initial SBP between the 2 groups. Patients in study group had lower initial NIHSS and ICH scores but higher GCS score than those in the control group. Using multivariant regression analysisto adjust for initial SBP, NIHSS, GCS and ICH scores, early initiation of oral antihypertensives was associated with significant shorter ICU LOS (median 2 vs 5, p =0.004), decreased duration of nicardipine infusion (55.5 ±60.1 vs 121.6 ±141.3, P =0.002), less pharmaceutical cost (median $14207 vs $ 29299, p =0.007) and total hospital cost (median $ 24564 vs $ 47366, p =0.007). After adjustment of confounders, there was also no significant difference in functional independence (mRS 0-2, 42.2% vs 17.1%, p =0.112) or mortality (6.7% vs 13.2%, p = 0.789) between the 2 groups. Conclusions: Early initiation of oral antihypertensive therapy is associated with reduced resource utilization and hospital cost in patients with hypertensive ICH.

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Physical therapy for young men having vertebrogenic lumbosacral pain

Health, sport, rehabilitation ◽

10.34142/hsr.2019.05.04.07 ◽

2019 ◽

Vol 5 (4) ◽

pp. 57

Author(s):

I.A. Sasko ◽

O.V. Beziazychna ◽

S.V. Manucharian

Keyword(s):

Physical Therapy ◽

Young Men ◽

Medical Rehabilitation ◽

Control Group ◽

Therapy Program ◽

Biological Studies ◽

Spine Mobility ◽

Motor Mode ◽

Physical Therapy Program ◽

And Control

Objective: to develop and experimentally explain physical therapy methods for vertebrogenic lumbosacral pain.Material and methods: 20 young men having vertebrogenic lumbosacral pain took part in the experiment at training motor mode, they were divided into two groups – experimental and control one, containing 10 people each. Men in experimental group had physical therapy according to original program, men from the control group – did it according to common recommendation of the Ministry of Health of Ukraine. Pedagogical and medico-biological studies have been carried out since October 2019 up to December 2019. Physical therapy courses in both experimental and control group lasted for two months. Clinical methods (medical history, visual examination), assessment according to Visual Analogue Scale of pain (VAS), lumbar spine mobility investigation, life quality evaluation according to Oswes try Disability Index questionnaire.Results: The presented efficiency of physical therapy program for training motor mode using the exercises on Redcord Suspension System: dynamic exercises to improve spine mobility, static exercises to strengthen and improve core and lower extremity muscles endurance, exercises using slings to improve proprioception; therapeutic massage according to Yefimenko methods: massage of lumbosacral region of spine, glutes, favorable number of procedures – is 15-20 ones; instrumental physiotherapy methods: ultrasound (1.2 – 1.4 W-cm2), double-pole interference (25-27 mA), Trabert’s current (7-8-12 mA).Conclusions: In the course of study undertaken we have made a conclusion that physical therapy program developed and introduced at the premises of Kinezio Medical Center of Physical Rehabilitation and Sport Medicine in Kharkov for young men having vertebrogenic lumbosacral pain allowed advancing efficiency of medical rehabilitation, is accessible for all specialized rehabilitation facilities and appears worthy of practical application.

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EFFECTIVENESS OF SUCTION ABOVE CUFF ENDOTRACHEAL TUBE (SACETT) IN PREVENTING VENTILATOR ASSOCIATED PNEUMONIA IN CRITICAL PATIENTS IN INTENSIVE CARE UNIT

Belitung Nursing Journal ◽

10.33546/bnj.503 ◽

2018 ◽

Vol 4 (4) ◽

pp. 380-389

Author(s):

Arfiyan Sukmadi ◽

Rr Sri Endang Pujiastuti ◽

Aris Santjaka ◽

Supriyadi Supriyadi

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Endotracheal Tube ◽

Intervention Group ◽

Control Group ◽

Ventilator Associated Pneumonia ◽

Mechanical Ventilator ◽

Control Group Design ◽

Bacterial Development ◽

Critical Patients

Background: The mechanical ventilator is an indispensable breathing tool in the Intensive Care Unit (ICU). But the mechanical ventilator is associated with the risk of Ventilator Associated Penumonia (VAP). VAP occurs due to poor hygiene of the endotracheal tube (ETT). ETT hygiene should be maintained to inhibit bacterial development in the lungs using suction above cuff endotracheal tube (SACETT) to prevent VAP.Objective: To analyze the effectiveness of SACETT in preventing Ventilator Associated Pneumonia (VAP) in critical patients in the ICU.Methods: This was a quasy experimental study with posttest only with control group design with 15 samples in intervention group (SACETT and Chlorhexidine 0.2%) and 15 in control group (ETT, Open Suction, and Chlorhexidine 0.2%) with purposive technique sampling. The Simplified Clnical Pulmonary Infection Score (CPIS) was used to measure VAP.Results: This study illustrates that there was no VAP incidence in the intervention group, and as much as 13.3% VAP in the control group. SACETT was more effective in preventing VAP than in standard ETT on day 4 (p = 0.001).Conclusion: SACETT is more effective in preventing VAP than standard ETT in the fourth day in patients with neurological, cardiovascular, urinary, digestive, and immune system disorders.

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Role of Ischemia Modified Albumin Serum Levels as an Oxidative Stress Marker in Children with Diabetic Ketoacidosis

Combinatorial Chemistry & High Throughput Screening ◽

10.2174/1386207322666191008214919 ◽

2019 ◽

Vol 22 (8) ◽

pp. 577-581

Author(s):

Mutlu U. Yazıcı ◽

Ganime Ayar ◽

Senay Savas-Erdeve ◽

Ebru Azapağası ◽

Salim Neşelioğlu ◽

...

Keyword(s):

Oxidative Stress ◽

Intensive Care Unit ◽

Intensive Care ◽

Diabetic Ketoacidosis ◽

Pediatric Patients ◽

Serum Levels ◽

Oxidative Stress Marker ◽

Control Group ◽

Study Group ◽

Ischemia Modified Albumin

Aim and Objective: Ischemia modified albumin (IMA) is a biomarker that has been introduced recently for use in the evaluation of oxidative stress. The aim of this study was to measure the ischemia modified albumin serum levels in pediatric patients with diabetic ketoacidosis (DKA) during acidosis and after the patient recovered from acidosis and to compare these with the control group. Materials and Methods: Pediatric patients with Type I diabetes mellitus (T1DM) who were admitted to the pediatric intensive care unit with the diabetic ketoacidosis were assigned as the study group and healthy children who were admitted to the outpatient clinic and decided as healthy after clinic and laboratory evaluation were selected as the control group. IMA and adjusted IMA levels were evaluated in the blood samples from the control group and the study group when admitted first time to the intensive care unit during the acidosis period (DKA before treatment, DKA-BT), and after recovering from acidosis (DKA after treatment, DKA-AT). Results: A total of 24 pediatric patients with diabetic ketoacidosis and 30 healthy control children matching age and sex were included in the current study. The albumin levels in pediatric patients with T1DM during DKA-BT were higher than the albumin levels after acidosis (4.101±0.373, 3.854±0.369 g/dL, respectively) (p<0.05). However, there was no significant difference when these values were compared to the control group. Mean values of IMA and Adj-IMA were statistically higher in DKAAT compared to the control group (0.748±0.150 vs 0.591±0.099, p< 0.001; 0.708±0.125 vs 0.607±0.824, p< 0.001, respectively). IMA and adjusted IMA levels measured after recovered from acidosis were significantly higher compared to the level of IMA during DKA (0.748±0.150 vs 0.606±0.105 as absorbance unit, p<0.001; 0.708±0.125 vs 0.625±0.100, p<0.05, respectively). Conclusion: In children with T1DM, even though acidosis recovered following the treatment in diabetic ketoacidosis, which is an oxidative stress marker, the ischemia modified albumin levels and adjusted ischemia modified albumin levels were high.

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Effect of Transcutaneous Electrical Neuromuscular Stimulation on Myopathy in Intensive Care Patients

American Journal of Critical Care ◽

10.4037/ajcc2018311 ◽

2018 ◽

Vol 27 (6) ◽

pp. 495-503 ◽

Cited By ~ 1

Author(s):

Evangelia Koutsioumpa ◽

Demosthenes Makris ◽

Athina Theochari ◽

Dimitra Bagka ◽

Stathis Stathakis ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Critical Illness ◽

Physical Therapy ◽

Intensive Care Unit Stay ◽

Controlled Trial ◽

University Hospital ◽

Control Group ◽

Neuromuscular Stimulation ◽

Open Label

Background Critical illness polyneuropathy or myopathy is a severe disorder that may adversely affect patients in the intensive care unit, resulting in reduced mobilization, decline in muscle mass, and prolonged recovery periods. Objective To examine whether the application of trans-cutaneous electrical neuromuscular stimulation (TENMS) reduces the incidence or severity of myopathy related to critical illness in intensive care unit patients. Methods A total of 80 patients aged 18 years or older with an intensive care unit stay of 96 hours or more and receipt of mechanical ventilation for 96 hours or more were initially enrolled in a prospective, open-label randomized controlled trial in a university hospital. Patients received either conventional physical therapy alone (control group) or conventional physical therapy plus TENMS (TENMS group) for 10 days. Myopathy was assessed histologically (by needle biopsy of the quadriceps muscles) on the 4th and 14th days of the intensive care unit stay. Results Of the 68 patients who completed the study, 27 (40%) had myopathy on the 14th day: 11 patients in the TENMS group (9 mild, 1 moderate, and 1 severe) and 16 patients in the control group (13 mild, 2 moderate, and 1 severe). Patients who progressed from mild to moderate or severe myopathy between the 4th and 14th days had significantly lower body mass index (P = .001) and longer time periods with inadequate nutrition (P = .049) compared with the other patients. Mean (SD) Rankin scale scores at 6 months were 3.2 (1.8) and 3.8 (2.1) in the TENMS and control groups, respectively (P = .09). Conclusion TENMS had no significant impact on myopathy in the critically ill patients in this study.

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A new look at the correction of COVID-19-mediated pulmonary gas exchange disorders

Kazan medical journal ◽

10.17816/kmj2021-362 ◽

2021 ◽

Vol 102 (3) ◽

pp. 362-372

Author(s):

I S Simutis ◽

G A Boyarinov ◽

M Yu Yuriev ◽

D S Petrovsky ◽

A I Kovalenko ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Gas Exchange ◽

Sodium Succinate ◽

Intensive Therapy ◽

Infusion Therapy ◽

Control Group ◽

Electrolyte Balance ◽

Study Group ◽

Coronavirus Infection

Aim. To assess the effect of meglumine sodium succinate on the effectiveness of basic therapy in correcting gas exchange abnormalities in patients with severe COVID-19 infection complicated by bilateral community-acquired pneumonia. Methods. The analysis of the effectiveness of therapy of 12 patients with a diagnosis of New coronavirus infection COVID-19 (confirmed), severe form U07.1. Complication: bilateral multifocal pneumonia was carried out. The patients were divided into two groups: 7 received, as part of standard therapy, a solution of meglumine sodium succinate in a daily dose of 5 ml/kg during stay in the intensive care unit; 5 patients received a similar volume of Ringer's solution and formed the control group. In the arterial and venous blood of all patients, the indicators of acid-base state and water-electrolyte balance, glycemia and lactatemia were measured at several stages: (1) at admission to the intensive care unit, (2) 24 hours after the start of intensive therapy, (3) after 812 hours, (4) after 24 hours. On the 28th day of observation, mortality, the duration of treatment in the intensive care unit and the incidence of thrombotic complications in the groups were assessed. The Friedman nonparametric hypothesis test was used to assess intragroup dynamics, and the nonparametric Mannhitney U test for intergroup comparisons. Results. In the group of patients who received meglumine sodium succinate, there was a significant decrease in the incidence of thromboembolic events during 28 days of treatment: myocardial ischemia event rate ratio from 0.89 [95% confidence interval (CI) 0.191.16] in the control group to 0.55 (95% CI 0.060.81) in the study group at p=0.043; pulmonary embolism event from 0.50 (95% CI 01.0) in the control group to 0.28 (95% CI 01.0) in the study group at p=0.041. There was also a decrease in the duration of intensive care unit length of stay to 6.11.1 days in the study group versus 8.91.3 days in the control group. Conclusion. Compared with standard infusion therapy, the use of meglumine sodium succinate leads to a faster normalization of ventilation-perfusion ratios in patients with severe coronavirus infection.

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