Prehabilitation Maximizing Functional Mobility in Patients With Cardiogenic Shock Supported on Axillary Impella.

IF 3.1 3区医学 Q2 ENGINEERING, BIOMEDICAL

ASAIO Journal Pub Date : 2024-08-01 Epub Date: 2024-03-14 DOI:10.1097/MAT.0000000000002170

Anju Bhardwaj, Ismael A Salas de Armas, Amanda Bergeron, R Michelle Sauer, Christa Gilley, Kathryn Reeves, Maria Patarroyo-Aponte, Mehmet H Akay, Manish Patel, Sachin Kumar, Jayeshkumar Patel, Juan Marcano, Sriram Nathan, Igor D Gregoric, Biswajit Kar

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引用次数: 0

Abstract

Physical therapy (PT) benefits for critically ill patients are well recognized; however, little data exist on PT in patients receiving temporary mechanical circulatory support. In this single-center retrospective study (February 2017-January 2022), we analyzed 37 patients who received an axillary Impella device (Abiomed, Danvers, MA) and PT to "prehabilitate" them before durable left ventricular assist device (dLVAD) implantation. The Activity Measure for Post-Acute Care (AM-PAC) Basic Mobility tool assessed the functional status at different points during admission. Immediately after Impella placement, the median AM-PAC score was 12.7 (interquartile range [IQR], 9-15), and the scores continued to significantly increase to 18.4 (IQR, 16-23) before dLVAD and up to 20.7 (IQR, 19-24) at discharge, indicating improved independence. No PT-related complications were reported. Thus, we hypothesize that critically ill patients initially deemed equivocal candidates may safely participate in PT while maximizing functional activities before dLVAD placement.

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通过康复训练最大限度地提高腋下冲击泵支持的心源性休克患者的功能活动能力。

理疗（PT）对重症患者的益处已得到广泛认可；然而，有关接受临时机械循环支持的患者进行理疗的数据却很少。在这项单中心回顾性研究（2017 年 2 月至 2022 年 1 月）中，我们分析了 37 名接受腋下 Impella 装置（Abiomed，马萨诸塞州丹佛斯）的患者，这些患者在植入耐用左心室辅助装置（dLVAD）前接受了物理治疗以进行 "预康复"。急性期后护理活动测量（AM-PAC）基本活动能力工具评估了入院期间不同阶段的功能状态。植入Impella后，AM-PAC得分中位数为12.7（四分位间距[IQR]，9-15），在植入dLVAD之前，得分持续显著上升至18.4（IQR，16-23），出院时则高达20.7（IQR，19-24），表明患者的独立性有所改善。未报告与 PT 相关的并发症。因此，我们假设最初被视为不确定人选的重症患者可以安全地参与 PT，同时在置入 dLVAD 之前最大限度地提高功能活动。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ASAIO Journal 医学-工程：生物医学

CiteScore

6.60

自引率

7.10%

发文量

651

审稿时长

4-8 weeks

期刊介绍： ASAIO Journal is in the forefront of artificial organ research and development. On the cutting edge of innovative technology, it features peer-reviewed articles of the highest quality that describe research, development, the most recent advances in the design of artificial organ devices and findings from initial testing. Bimonthly, the ASAIO Journal features state-of-the-art investigations, laboratory and clinical trials, and discussions and opinions from experts around the world. The official publication of the American Society for Artificial Internal Organs.