Example: stock market

ICUでのリハビリテーション - JSEPTIC

49 . ICU . 2016 1 .. -1- ICU . 2009 Schweickert 1) . ICU Early Mobilization . ICU . Early Mobilization Early Mobilization . 2) .. 3) ICU . 4) 2014 . JSEPTIC . ~ . ~ ICU .. 1) Schweickert WD, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009; 373: 1874-1882. 2) Bakhru RN, et al. An Environmental Scan for Early Mobilization Practices in ICUs. Crit Care Med. 2015; 43: 2360-9. 3) Hodgson CL, et al. Expert consensus and recommendations on safety criteria for active mobilization of mechanically ventilated critically ill adults. Crit Care. 2014; 18: 658. 4) Sommers J, et al. Physiotherapy in the intensive care unit: an evidence-based, expert driven, practical statement and rehabilitation recommendations.

- 1 - 簡単アンケート第49弾: icuでのリハビリテーション (2016年1月実施) JSEPTIC臨床研究委員会 アンケート作成者:

Tags:

  Jseptic

Information

Domain:

Source:

Link to this page:

Please notify us if you found a problem with this document:

Other abuse

Transcription of ICUでのリハビリテーション - JSEPTIC

1 49 . ICU . 2016 1 .. -1- ICU . 2009 Schweickert 1) . ICU Early Mobilization . ICU . Early Mobilization Early Mobilization . 2) .. 3) ICU . 4) 2014 . JSEPTIC . ~ . ~ ICU .. 1) Schweickert WD, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009; 373: 1874-1882. 2) Bakhru RN, et al. An Environmental Scan for Early Mobilization Practices in ICUs. Crit Care Med. 2015; 43: 2360-9. 3) Hodgson CL, et al. Expert consensus and recommendations on safety criteria for active mobilization of mechanically ventilated critically ill adults. Crit Care. 2014; 18: 658. 4) Sommers J, et al. Physiotherapy in the intensive care unit: an evidence-based, expert driven, practical statement and rehabilitation recommendations.

2 Clin Rehabil. 2015; 29: 1051-1063.. JSEPTIC ICU . JSEPTIC JSEPTIC .. ICU .. 318 . -2- 1 . 1. 2. 3. 4. 5. 6.. 7. 8. 9. 10.. 11.. 2 ICU (Pronovost ). 1. Closed ICU ( ). 2. Mandatory critical care consultation ( ICU ). 3. Elective critical care consultation ( ). 4. No critical care physician (ICU ). 5.. 0% 10% 20% 30% 40%. Closed ICU ( ) Mandatory critical care consultation ( ICU . ). Elective critical care consultation ( . ). No critical care physician (ICU ) -3- 2 . 0% 10% 20% 30% 40%. Closed ICU ( ) . Mandatory critical care consultation ( ICU . ). Elective critical care consultation ( .. ). No critical care physician (ICU ) . 2 . Closed ICU . 3 ICU .. 1. ICU . 2. ICU . 3. ICU . 4. ICU . 5 . 0% 10% 20% 30% 40% 50% 60% 70% 80%. ICU .. ICU .. ICU .. ICU -4.

3 ICU . PT OT .. 3 . 0% 50% 100%. ICU. 0%.. ICU.. ICU . 0%.. ICU 0%. 0%. 3 .. 4 ICU . A: B C D .. 0% 20% 40% 60%. 0% 20% 40% 60% 80%.. A . B C D -5- .. 0% 20% 40% 60% 80% 0% 20% 40% 60%. A . B .. C . D .. 0% 20% 40% 60% 80% 0% 20% 40% 60%. A B .. C . D .. 0% 20% 40% 60% 80% 0% 20% 40% 60%. A B .. C . D -6- .. 0% 20% 40% 60% 80% 0% 20% 40% 60%.. A .. B C D .. 0% 10% 20% 30% 40% 50% 60% 0% 20% 40% 60%. A .. B C D .. 0% 10% 20% 30% 40% 50% 0% 20% 40% 60%. A .. B C D -7- 4 . PT .. ICU .. 5 ICU .. 1 2 3 . 4. ICU . 5.. 0% 10% 20% 30% 40%. ICU .. -8- . CABG DA Dr .. ICU .. ICU . ICU .. Vitals G-up .. ICU .. PCI .. 5 . 0% 50% 100%.. 5 . PT .. ICU . -9- . Hodgson CL, et al. Expert consensus and recommendations on safety criteria for active mobilization of mechanically ventilated critically ill adults.

4 Crit Care. 2014;18(6):658. Sommers J, et al. Physiotherapy in the intensive care unit: an evidence-based, expert driven, practical statement and rehabilitation recommendations. Clin Rehabil. 2015;29(11):1051-63.. MB. Med Reha 2015;160:69-77 . 6.. A B . C D ICU . PEEP 16cmH2O .. 0% 20% 40% 60%. 0% 20% 40% 60%. A A .. B B .. C . C D ICU . D ICU .. PEEP 5cmH2O .. 0% 20% 40% 60% 80% 0% 20% 40% 60%.. A A .. B B .. C C D ICU . D ICU .. - 10 - 30 / .. 0% 10% 20% 30% 40% 50% 60% 0% 20% 40% 60%. A A .. B B .. C . C .. D ICU D ICU .. SpO2 90% .. 0% 10% 20% 30% 40% 50% 60%. 0% 20% 40% 60%. A . A .. B . B . C .. C D ICU .. D ICU .. g/kg/ MAP65mmHg .. 0% 20% 40% 60%. 0% 10% 20% 30% 40% 50% 60%. A .. A B .. B . C .. C D ICU .. D ICU .. - 11 - g/kg/ MAP50mmHg .. 0% 20% 40% 60% 80% 100%.

5 0% 10% 20% 30% 40% 50%. A 0%. A B B 0%.. C . C D ICU 0%. D ICU .. 70 50 / .. 0% 10% 20% 30% 40% 50% 0% 20% 40% 60%.. A A .. B . B .. C C D ICU . D ICU .. 70 110 / .. 0% 10% 20% 30% 40% 50% 60% 0% 20% 40% 60%. A A . 0%.. B B .. C 0%. C D ICU . D ICU 0%.. - 12 - RASS -4 .. 0% 10% 20% 30% 40% 50% 0% 20% 40% 60%. A A .. B B .. C . C D ICU . D ICU .. 0% 10% 20% 30% 40% 50% 0% 20% 40% 60%. A . A .. B 0%. B .. C . C D ICU .. D ICU .. 0% 20% 40% 60% 0% 20% 40% 60%. A A .. B B .. C C D ICU D ICU .. - 13 - 6 .. 30 30 . ICU .. Range of Motion .. ARDS Pendeluft .. 7 65 ICU . ( g/kg/ ) 65mmHg .. 1. 2 3 4 5 6 . 0% 10% 20% 30% 40% 50% 60%. - 14 - .. passive exercise EMS .. CPAP SIMV 30 . active-ex .. Head up try .. ADL . ROM .. ROM . : .. LDH .. 1-2m . - 15 - .. 7 . 0% 20% 40% 60% 80%.

6 ROM . 7 .. 13 . 65mmHg . Early goal directed therapy EGDT 8- 12mmHg 65mmHg SvO2 65 . SvO2 65mmHg . ICU .. Resuscitation .. - 16 - 8 A/C, PCV, FIO2 , 8 cmH2O, PEEP 10 cmH2O, 20 / .. 1. 2 3 4 5 6 . 0% 20% 40% 60% 80%.. 7 .. 1 . FiO2 PEEP 10 H2O . Head up 60 try .. weaning . or . A/C . NMES .. - 17 - 1 .. ADL . passive exercise EMS.. PSV .. EMS.. - 18 - 8 . 0% 20% 40% 60% 80% 100%.. 8 . VS .. 5.. - 19 - 9 6L/ 30 /. SpO2 90% .. 1. 2 3 4 5 6 . 0% 10% 20% 30% 40% 50% 60%.. nasal high-flow . ROM .. 60 SPO2 .. tube .. NPPV HFNC .. desaturation .. - 20 - . 30 / SpO2 90% 30 / . SpO2 90% .. 30 SPO2 90 . SPO2 .. 30 /min .. Spo2 .. 9 . 0% 20% 40% 60%.. 0%. 0%. 0%. 9 .. 6L/ 30 / SpO2 90% .. 30 / .. - 21 - 10 70 ICU . (CRRT) . ( g/kg/ ) 65mmHg CRRT .. 1. 2 3 4 5 6.

7 0% 10% 20% 30% 40% 50% 60%.. ADL . CRRT . CRRT AKI .. CRRT . Head up try . NMES. passive exercise EMS. ROM RASS . ROMEX.. - 22 - CRRT .. CRRT CHDF .. 10 . 0% 20% 40% 60%.. 0%. 0 . 0%. 0%. - 23 - 10 .. POD0-1 . CRRT . Vascath . POD2-3 .. 11 ICU . 1 2 3 4 5 ADL . 6 7 . 0% 20% 40% 60% 80% 100%. ADL . ADL QOL . ASD PTSD . ICU-AW . SF36 .. - 24 - .. ICU .. 11 . 0% 20% 40% 60% 80% 100%.. ADL .. - 25 - 12 ICU . A B C .. 0% 10% 20% 30% 40% 50% 0% 20% 40% 60%. A A . B B . C C .. 0% 10% 20% 30% 40% 50% 60% 70%. 0% 20% 40% 60%. A A 0%.. B B . C C 0%.. 0% 20% 40% 60% 80% 0% 50% 100%. A A 0%.. B . B C 0%. C - 26 - .. 0% 50% 100%. 0% 20% 40% 60% 80%. A . A . B 0%. B C 0%. C .. 0% 20% 40% 60%. 0% 10% 20% 30% 40% 50% 60% 70%. A A . B B . C C . 12 .. ICU .. - 27 - . 2.

8 ICU .. 13 ICU .. ICU .. Pt . ICU 20min Pt 20min .. ICU PT Nrs . PT ICU .. 6 . - 28 - ARDS .. ICU . ICU .. ICU .. ICU PT .. Dr,Ns .. ( 6 ) .. ICU 70 .. ICU .. ICU .. ICU . ICU . - 29 - .. ICU .. ICU .. ICU .. PT .. ICU .. - 30 - .. ICU .. ICU . ICU .. ICU .. ICU .. ICU . Dr Dr .. - 31 - ICU .. ICU .. ICU .. ICU ICU .. ICU .. ICU .. ICU .. ICU .. - 32 - .. PT .. ICU .. ICU ICU .. 6 .. 13 . ICU .. ICU . ICU .. - 33.


Related search queries