Effect Of Early Comprehensive Rehabilitation Intervention On The Occurrence Of Delirium In Mechanically Ventilated Patients

BackgroundDelirium is a consciousness and attention disorder caused by many reasons.Delirium that occurs in the intensive care unit(ICU)is called ICU delirium.Its main characteristics are fluctuating consciousness level changes,inattention,thinking disorder and sleep disturbance.The occurrence of ICU delirium is an important reason for the high mortality of patients.Once delirium occurs,it will not only lead to prolonged mechanical ventilation(MV)time for patients,but also increase the incidence of nosocomial infections and hospital mortality.Survivors can also be left with varying degrees of cognitive dysfunction,which can also be used by nursing workers and others in the ICU.Patients bring great distress,and ICU complications increase.There are many risk factors that promote the occurrence of delirium in the intensive care unit.ICU patients have a high incidence of delirium due to the severe primary disease,various invasive procedures,accumulation of a large number of analgesic and sedative drugs,and sleep disturbances,especially in mechanically ventilated patients.In order to prevent human-machine confrontation in mechanically ventilated patients,medical staff in the intensive care unit often provide deep sedation.In addition,mechanically ventilated patients cannot speak and express their inner thoughts.This makes it impossible for medical staff to detect abnormal symptoms of patients in time and the closed ICU environment.Causes a higher incidence of delirium.Therefore,exploring how to reduce the incidence of delirium in mechanically ventilated patients has important clinical significance.A large number of foreign studies have proved that early rehabilitation is helpful to the management of delirium,but the domestic preventive treatment plan for delirium only stays at the level of conventional treatment,and the effect of early rehabilitation intervention on the occurrence of delirium in mechanically ventilated patients is still unclear.ObjectiveThis study aims to observe the effect of early comprehensive rehabilitation intervention on the occurrence of delirium in mechanically ventilated patients.MethodsA selection of 104 mechanically ventilated patients who were treated in the Department of Critical Care Medicine of a Hospital Affiliated to a University from January 2019 to January 2020 and met the selection criteria were randomly divided into observation group and control group according to the digital table method.The patients gave up treatment or withdrew from the study because 5 patients died during the ICU(including 1 in the observation group and 4 in the control group).In the end,99 patients completed the study,51 in the observation group and 48 in the control group.Patients in the two groups were given ICU routine care.On this basis,patients in the observation group were assisted by rehabilitation therapists for early comprehensive rehabilitation intervention combining exercise therapy,respiratory function training and cognitive function training.The intensity of rehabilitation intervention should be adjusted gradually and continuously according to the patient’s completion.The incidence of delirium,the duration of delirium,the duration of mechanical ventilation,and the use of analgesics and sedatives were compared between the two groups of patients within 14 days of ICU hospitalization.Use spss19.0 version statistical software package for statistical data analysis and processing.ResultsICU delirium occurred in 37 of 99 patients,with an incidence rate of 37.4%,including 14 in the observation group and 23 in the control group.The incidence of delirium,the duration of delirium and the duration of mechanical ventilation in the observation group were less than those in the control group(p<0.05),and the differences were statistically significant.There was no significant difference in the time,type and dosage of analgesic and tranquilizers between the two groups(p>0.05).ConclusionEarly comprehensive rehabilitation intervention can reduce the incidence of delirium in patients with mechanical ventilation,shorten the duration of delirium and the duration of mechanical ventilation.