Meta-analysis of the effects of bundle interventions on ICU-acquired weakness intervention.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-09-05 DOI:10.3233/THC-241542

Yan Zhou, Yubao Liu, Yutong Han, Hongxia Yan

{"title":"Meta-analysis of the effects of bundle interventions on ICU-acquired weakness intervention.","authors":"Yan Zhou, Yubao Liu, Yutong Han, Hongxia Yan","doi":"10.3233/THC-241542","DOIUrl":null,"url":null,"abstract":"Background: Intensive care unit acquired weakness (ICU-AW) is a secondary neuromuscular complication in critically ill patients, characterized by profound weakness in all four limbs. Studies have shown that bundles of care are nursing strategies that combine a series of evidence-based interventions, which collectively optimize patients' clinical outcomes compared to individual interventions.Objective: This study aims to conduct a meta-analysis of the effects of bundle interventions on ICU-AW deeply exploring the characteristics of bundle interventions, patient outcomes related to ICU-AW, and primarily investigating the effects of bundle interventions on ICU-AW. The main focus is to explore the clinical value of bundle interventions in treatment of ICU-acquired weakness in patients.Methods: Computer and manual searches were conducted using keywords to retrieve relevant studies on the effects of bundle interventions on ICU-AW from databases such as PubMed, Web of Science, Cochrane Library and EMbase. The search period ranged from database inception to the present. The control group received standard ICU care, including basic nursing, while the intervention group received bundle nursing interventions.Results: A total of 10 randomized controlled trials (RCTs) involving 1545 participants (790 in the intervention group and 755 in the control group) were included. Meta-analysis results showed that the intervention group had significantly higher muscle strength (MD = 7.41, 95% CI: 6.65-8.16, P< 0.00001) and daily living ability (MD = 34.01, 95% CI: 32.54-35.48, P< 0.00001) than the control group. Additionally, the incidence of ICU-AW (OR = 0.39, 95% CI: 0.26-0.59, P< 0.00001), mechanical ventilation time (MD =-3.71, 95% CI: -3.58∼-2.76, P< 0.0001), and ICU length of stay (MD =-2.73, 95% CI: -3.14∼-2.31, P< 0.00001) were significantly lower in the intervention group than in the control group.Conclusion: ICU-AW has a severe negative impact on the recovery and functional restoration of ICU patients, increasing the treatment complexity for healthcare providers and the mortality and disability rates for patients. The bundled care approach may help reduce the incidence of ICU-AW, promote the restoration of daily activity function, enhance muscle strength, and reduce ICU stay and mechanical ventilation time for ICU patients. However, the long-term effects of bundle interventions still require further in-depth research.","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":null,"pages":null},"PeriodicalIF":16.4000,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Accounts of Chemical Research","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.3233/THC-241542","RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CHEMISTRY, MULTIDISCIPLINARY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Intensive care unit acquired weakness (ICU-AW) is a secondary neuromuscular complication in critically ill patients, characterized by profound weakness in all four limbs. Studies have shown that bundles of care are nursing strategies that combine a series of evidence-based interventions, which collectively optimize patients' clinical outcomes compared to individual interventions.

Objective: This study aims to conduct a meta-analysis of the effects of bundle interventions on ICU-AW deeply exploring the characteristics of bundle interventions, patient outcomes related to ICU-AW, and primarily investigating the effects of bundle interventions on ICU-AW. The main focus is to explore the clinical value of bundle interventions in treatment of ICU-acquired weakness in patients.

Methods: Computer and manual searches were conducted using keywords to retrieve relevant studies on the effects of bundle interventions on ICU-AW from databases such as PubMed, Web of Science, Cochrane Library and EMbase. The search period ranged from database inception to the present. The control group received standard ICU care, including basic nursing, while the intervention group received bundle nursing interventions.

Results: A total of 10 randomized controlled trials (RCTs) involving 1545 participants (790 in the intervention group and 755 in the control group) were included. Meta-analysis results showed that the intervention group had significantly higher muscle strength (MD = 7.41, 95% CI: 6.65-8.16, P< 0.00001) and daily living ability (MD = 34.01, 95% CI: 32.54-35.48, P< 0.00001) than the control group. Additionally, the incidence of ICU-AW (OR = 0.39, 95% CI: 0.26-0.59, P< 0.00001), mechanical ventilation time (MD =-3.71, 95% CI: -3.58∼-2.76, P< 0.0001), and ICU length of stay (MD =-2.73, 95% CI: -3.14∼-2.31, P< 0.00001) were significantly lower in the intervention group than in the control group.

Conclusion: ICU-AW has a severe negative impact on the recovery and functional restoration of ICU patients, increasing the treatment complexity for healthcare providers and the mortality and disability rates for patients. The bundled care approach may help reduce the incidence of ICU-AW, promote the restoration of daily activity function, enhance muscle strength, and reduce ICU stay and mechanical ventilation time for ICU patients. However, the long-term effects of bundle interventions still require further in-depth research.

查看原文本刊更多论文

捆绑式干预对重症监护室获得性虚弱干预效果的 Meta 分析。

背景：重症监护病房获得性肌无力（ICU-AW）是重症患者继发的神经肌肉并发症，其特征是四肢极度无力。研究表明，捆绑护理是结合一系列循证干预措施的护理策略，与单个干预措施相比，捆绑护理能共同优化患者的临床疗效：本研究旨在对捆绑式干预对 ICU-AW 的影响进行荟萃分析，深入探讨捆绑式干预的特点、与 ICU-AW 相关的患者预后，主要研究捆绑式干预对 ICU-AW 的影响。主要探讨捆绑式干预在治疗ICU获得性虚弱患者中的临床价值：使用关键字进行计算机和人工检索，从 PubMed、Web of Science、Cochrane Library 和 EMbase 等数据库中检索有关捆绑式干预对 ICU-AW 影响的相关研究。检索时间从数据库建立之初到现在。对照组接受包括基础护理在内的标准 ICU 护理，干预组接受捆绑护理干预：结果：共纳入了 10 项随机对照试验（RCT），涉及 1545 名参与者（干预组 790 人，对照组 755 人）。元分析结果显示，干预组的肌力（MD = 7.41，95% CI：6.65-8.16，P< 0.00001）和日常生活能力（MD = 34.01，95% CI：32.54-35.48，P< 0.00001）明显高于对照组。此外，干预组的 ICU-AW 发生率（OR = 0.39，95% CI：0.26-0.59，P< 0.00001）、机械通气时间（MD =-3.71，95% CI：-3.58∼-2.76，P< 0.0001）和 ICU 住院时间（MD =-2.73，95% CI：-3.14∼-2.31，P< 0.00001）均显著低于对照组：ICU-AW对ICU患者的康复和功能恢复有严重的负面影响，增加了医护人员治疗的复杂性，提高了患者的死亡率和致残率。捆绑式护理方法有助于降低 ICU-AW 的发生率，促进患者恢复日常活动功能，增强肌肉力量，减少 ICU 患者在 ICU 的住院时间和机械通气时间。然而，捆绑干预的长期效果仍需进一步深入研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.