Κλινική Άσκηση στη Φυσικοθεραπεία Καρδιοαναπνευστικών Παθήσεων (Θ & Ε)

Ειρήνη Γραμματοπούλου

Περιγραφή

Σκοπός του μαθήματος είναι η εξοικείωση των φοιτητών με την προσέγγιση ασθενών με παθήσεις του αναπνευστικού συστήματος, τον κλινικό συλλογισμό και τη λήψη αποφάσεων σε κλινικό περιβάλλον. Οι φοιτητές καλούνται να συνδέσουν τη θεωρία με την τεκμηριωμένη γνώση στην κλινική πρακτική. Η κλινική πρακτική εστιάζεται κυρίως α) στην αξιολόγηση του χρόνιου αναπνευστικού ασθενή, του ασθενή της μονάδας εντατικής θεραπείας-ΜΕΘ και του χειρουργημένου ασθενή (πνεύμονες-καρδιά-άνω κοιλία), β) στη χάραξη στόχων και εφαρμογή εξατομικευμένων παρεμβατικών προγραμμάτων σε κάθε κλινικό περιστατικό και γ) στην κλινική σημαντικότητα της επαναξιολόγησης αναφορικά με την αποτελεσματικότητα–καταλληλότητα της επιλεγμένης παρέμβασης.

Λέξεις Κλειδιά: PULMONARY Rehabilitation, Respiratory Physiotherapy, Self-management, Intensive care unit-ICU, Inspiratory muscle training in the ICU, Noninvasive ventilation, mobilization.

Θεματικές Ενότητες

Αναλύεται η επίδραση της Φυσικοθεραπευτικής παρέμβασης  στην αλλαγή και υιοθέτηση συμπεριφοράς των ασθενών με χρόνιες αναπνευστικές  παθήσεις όπως το άσθμα και η χρόνια αποφρακτική πνευμονοπάθεια.

Βιβλιογραφία

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  14. Schwarzer, R., & Jerusalem, M. (1995). Generalized self-efficacy scale. In: L. Weinman, S. Wright, & M. Johnston (Eds), Measures in health psychology: A user’s portfolio. Causal and control beliefs (pp. 35-37). Wingsor, UK: Nfer-Nelson.

Λέξεις Κλειδιά

Κοινωνικο-γνωστικά μοντέλα, μοντέλο πεποιθήσεων για την Υγεία, μετα-Θεωρητικό μοντέλο, ενδυνάμωση, ενίσχυση, αυτο-αποτελεσματκότητα.

Ανάλυση των συστημάτων χορήγησης και διανομής οξυγονόνου σε χρόνιους αναπνευστικούς ασθενείς.

 Βιβλιογραφία

  1. Adde F, Alvarez A, Barbisan B, Guimaraes B: Recommendations for long-term home oxygen therapy in children and adolescents. J Pediatr (Rio J), 2013; 89(1): 6-17.
  2. American Thoracic Society: ATS: Oxygen Sources and Delivery Devices/Home Oxygen Therapy. www.thoracic.org/clinical/copd-guidelines/for-health-professionals/management-of-stable-copd/long-term-oxygen-therapy, 2014
  3. Australian Institute of Health and Welfare: Monitoring pulmonary rehabilitation and long-term oxygen therapy for people with chronic obstructive pulmonary disease (COPD) in Australia.         www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129545159, 2013
  4. British Thoracic Society: BTS: Clinical Component for the Home Oxygen Service in England and Wales. www.brit-thoracic.org.uk/Delivery-ofRespiratory-Care/oxygen-Use-in the-Home.aspx, 2006.
  5. BTS: O΄ Driscoll BR, Howard LS, Davison AG. BTS guideline for emergency oxygen use in adult patients. Thorax ,2008; 63(Sup.VI): 1-73.
  6. BTS: Josephs L, Coker R, Thomas M. Managing patients with stable respiratory disease planning air travel: A primary care summary of the British Thoracic Society recommendations. Prim Care Respir J, 2013; 22(2): 234-238.
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Λέξεις Κλειδιά

Οξυγονοθεραπεία, συστήματα χορήγησης οξυγόνου, οδηγίες εφαρμογής

Ανάλυση περιστατικών άσθματος, χρόνιας αποφρακτικής πνευμονοπάθειας, κυστικής ίνωσης (αξιολόγηση, βραχυ-μακροπρόθεσμοι στόχοι, τεχνικές, ανατροφοδότηση)

Βιβλιογραφία

  1. Global initiative for asthma (GINA) Global strategy for asthma management and prevention 2011 (update). http: //www.ginasthma.org.
  2. Grammatopoulou E, Skordilis E, Stavrou N, Myrianthefs P, Karteroliotis K, Baltopoulos G, Koutsouki D. The effect of physiotherapy-based breathing retraining on asthma control. Journal of Asthma Journal of Asthma, 2011; 48:593-601.
  3. Grammatopoulou E, Stavrou N, Myrianthefs P, Karteroliotis K, Baltopoulos G, Behrakis P, Koutsouki D. Asthma control in Greece: Validity and reliability evidence of the Asthma Control Test-ACT in Greece. Journal of Asthma, 2011; 48:57-64.
  4. Grammatopoulou E, Skordilis E, Koutsouki D, Baltopoulos G. An 18-item standardised Asthma Quality of Life Questionnaire. Quality of Life Research. 2008; 17(2):323-332.
  5. Grammatopoulou E, Haniotou A, Douka G, Koutsouki D. Factors associated with BMI in Greek adults with asthma. Journal of Asthma, 2010; 47, 276-280.
  6.  Global initiative for Chronic Obstructive Pulmonary Diseases (GOLD) Global strategy for the diagnosis, management and prevention 2006 (update). http: //www. goldcopd.org.
  7. Gosselink R. Breathing techniques in patients with chronic obstructive pulmonary disease (COPD). Chronic Respiratory Disease, 2004; 1: 163-172.
  8. Guidelines for Pulmonary Rehabilitation Programs, American Association of Cardiovascular and Pulmonary Rehabilitation. Human Kinetics, 2011.

Λέξεις Κλειδιά

Χρόνια Αποφρακτική Πνευμονοπάθεια, χρόνια βρογχίτιδα, πνευμονικό εμφύσημα, πνευμονική αποκατάσταση

Αναλυτική  παρουσίαση των προγραμμάτων αναπνευστικής αποκατάστασης στη ΧΑΠ, ερευνητική τεκμηρίωση.

Βιβλιογραφία

  1. An Official American Thoracic Society/European Respiratory Society Statement: Key Concepts and Advances in Pulmonary Rehabilitation. American Thoracic Society Documents. American Journal of Respiratory and Critical Care Medicine, vol. 188, p. e13-e64, 2013.
  2. Guidelines for pulmonary rehabilitation programs. 4th Edition. American Association of Cardiovascular and Pulmonary Rehabilitation. Human Kinetics, 2011.
  3. Gosselink R. Breathing techniques in patients with chronic obstructive pulmonary disease (COPD). Chronic Respiratory  Disease. 2004; 1(3):163-72.
  4. Weiner P, Magadle R, Beckerman M, Weiner, M and Berar-Yanay N. Comparison of Specific Expiratory, Inspiratory, and Combined Muscle Training Programs in COPD. CHEST 2003; 124:1357–1364.
  5. Vogiatzis, I., Nanas, S., & Roussos, C. (2002). Intervall training as an alternative modality to continuous exercise in patients with COPD. European Respiratory         Journal, 20, 12-19.
  6. British Thoracic Society Standards of Care Subcommittee on Pulmonary Rehabilitation. BTS Statement. (2001). Pulmonary rehabilitation. Thorax, 56, 827-834.
  7. Dechman, G., & Wilson, R. (2004). Evidence underlying breathing retraining in     people with stable chronic obstructive pulmonary disease. Physical Therapy,  84(12), 1189-1197.
  8. Fabbri L.M., & Hurd, S.S (2003). Global strategy for diagnosis, management and prevention of COPD: 2003 update. European Respiratory Journal, 22, 1-2.
  9. Hill, N.S. (2006). Pulmonary rehabilitation. Proceedings of the American Thoracic  Society, 3, 66-74. 
  10. Maltais, F., LeBlanc, P., Jobin, J., Berube, C., Bruneau, J., Carrier, L., Breton, M.J., Falardeau, G., & Belleau, R. (1997). Intensity of training and physiologic adaptation in patients with chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine, 155, 555-561.

Λέξεις Κλειδιά

Χρόνια αποφρακτική πνευμονοπάθεια, χρόνια βρογχίτιδα, πνευμονικό εμφύσημα, πνευμονική αποκατάσταση

Αναλυτική περιγραφή της διαδικασίας εφαρμογής της αναρρόφησης των βρογχικών εκκρίσεων

Βιβλιογραφία

  1. Κιέκκας Π, και συν. Βρογχοαναρρόφηση τραχειοσωλήνα / τραχειοστομίου. Στο Εντατική Θεραπεία και Επείγουσα Ιατρική «Κατευθυντήριες οδηγίες» Επιμέλεια Γ. Μπαλτόπουλος, Εκδ CYM, 2010; 2333-2338.
  2. AARC Clinical Practice Guidelines. Endotracheal suctioning of mechanically ventilated patients with artificial airways. Respir Care 2010; 55:758-764.
  3. Bourgault AM, et al. Effects of endotracheal tube suctioning on arterial oxygen tension and heart rate variability. Biol Res Nurs 2006; 7:268-278.
  4. Celik SS & Elbas NO. The standard of suction for patients undergoing endotracheal intubation. Intensive Crit Care Nurs 2000; 16:191-198
  5. Celik SA & Kanan N. A curent conflict: use of isotonic sodium chloride solution on endotracheal suctioning in critically ill patients. Dimens Crit Care Nurs 2006; 25:11-14.
  6. Topeli A et al. Comparison of the effect of closed versus open endotracheal suction systems on the development of ventilator associated pneumonia. J Hosp Infect 2004; 58:14-19.
  7. Maggiore SM et al. Prevention of endotracheal suctioning induced alveolar derecruitment in acute lung injury. Am J Respir Crit Care Med 2003; 167:1215-1224.
  8. Oh H & Seo W. A meta analysis of the effects of various interventions in preventing endotracheal suction induced hypoxemia. J Clin Nurs 2003; 12:912-924.

Λέξεις Κλειδιά

Τραχειοβρογχικό δένδρο, αναρρόφηση, καθετήρες, ρευστοποίηση

Κριτήρια ένταξης και αποκλεισμού, πρωτόκολλα εφαρμογής ΜΕΜΑ και ερευνητική τεκμηρίωση

Βιβλιογραφία

  1. Scott et al. The role of time and pressure on alveolar recruitment. Journal of Applied Physiology, 2009; 106: 757-765.
  2. Antonelli M, et al. Predictors of failure of noninvasive positive pressure ventilation in patients with acute hypoxemic respiratory failure: Α multi-center study. Intensive care medicine, 2001; 27: 1718-1728.
  3. Antonelli M, et al. A comparison of noninvasive positive-pressure ventilation and conventional mechanical ventilation in patients with acute respiratory failure. New England Journal of Medicine, 1998; 339: 429-435.
  4. Antonelli M, et al. A multiple-center survey on the use in clinical practice of noninvasive ventilation as a first-line intervention for acute respiratory distress syndrome. Critical care medicine, 2007; 35: 18-25.
  5. Beale D. CPAP vs. BiPAP. JEMS, 2008; 33(1):22
  6. Celebi S, et al. Pulmonary effects of noninvasive ventilation combined with the recruitment maneuver after cardiac surgery. Anesthesia & Analgesia, 2008; 107: 614-619.
  7.  Spruit MA, Thomeer MJ, Gosselink R, et al. Skeletal muscle weakness in patients with sarcoidosis and its relationship with exercise intolerance and reduced health status. Thorax 2005; 60: 32–38.
  8. Thomas JA, McIntosh JM. Are incentive spirometry, intermittent positive pressure breathing, and deep breathing exercises effective in the prevention of postoperative pulmonary complications after upper abdominal surgery? A Systematic Overview and Meta-analysis. Phys Ther. 1994; 74:3-10.
  9. Çelikel T, et al. Comparison of noninvasive positive pressure ventilation with standard medical therapy in hypercapnic acute respiratory failure. Chest, 1998; 106: 1636-1642.
  10. Conti G, et al. Noninvasive vs. conventional mechanical ventilation in patients with chronic obstructive pulmonary disease after failure of medical treatment in the ward: a randomized trial. Intensive care medicine, 2002q 28: 1701-1707.
  11. Denehy L, Berney S. The use of positive pressure devices by physiotherapists. Eur Respir J, 2001; 17: 821-829.
  12. Evans TW. International Consensus Conferences in Intensive Care Medicine: non-invasive positive pressure ventilation in acute respiratory failure. Intensi Care Med,  2001; 27: 166-178.
  13. Girou E, et al. Association of noninvasive ventilation with nosocomial infections and survival in critically ill patients. Jama, 2000; 284: 2361-2367.
  14. Gómez-Merino E, et al. Mechanical insufflation-exsufflation: Pressure, volume, and flow relationships and the adequacy of the manufacturer's guidelines. American Journal of Physical Medicine & Rehabilitation , 2002; 81: 579-583.
  15. Grasso S, et al. Effects of recruiting maneuvers in patients with acute respiratory distress syndrome ventilated with protective ventilatory strategy. Anesthesiology, 2002; 96: 795-802.
  16. Guerin C, et al. Facial mask noninvasive mechanical ventilation reduces the incidence of nosocomial pneumonia. Intens Care Med, 1999; 23: 1024-1032.
  17. Holland AE, et al. Non-invasive ventilation assists chest physiotherapy in adults with acute exacerbations of cystic fibrosis. Thorax, 2003; 58: 880-884.
  18. Pryor JA. Physiotherapy for airway clearance in adults. Eur Res J, 1999; 14: 1418-1424.

Λέξεις Κλειδιά

Μη επεμβατικός μηχανικός αερισμός

Κριτήρια για μηχανική υποστήριξη της αναπνοής, αναπνευστήρες, μοντέλα μηχανικού αερισμού, ρυθμίσεις του αναπνευστήρα, παρακολούθηση μηχανικά αεριζόμενου ασθενούς, φροντίδα του μηχανικά αεριζόμενου ασθενούς

Βιβλιογραφία

  1. Larsson A. Mechanical ventilation - Skills and techniques Update 2011.
  2. An  ESICM Multidisciplinary Distance Learning Programme for Intensive Care    
  3. Training  (available on line)
  4. Grossbach I, Chlan L, Tracy MF. Overview of mechanical ventilatory support and management of patient- and ventilator-related responses. Crit Care Nurse, 2011; 31:30-44
  5. Marini J. Mechanical ventilation: past lessons and the near future. Critical Care 2013; 17(Suppl 1):S1  
  6. Ranieri M, Rubenfeld G, Thompson T, et. al. The ARDS definition task force. JAMA, 2012; 307(23):2526-33 
  7. Ferguson ND, Fan E, Camporota L. The Berlin definition of ARDS: an expanded rationale, justification, and supplementary material Intensive Care Med 2012;38:1573-82
  8. Richman PS, Baram D, Varela M, Glass PS. Sedation during mechanical ventilation: a trial of benzodiazepine and opiate in combination. Crit Care Med 2006, 34:1395-1401
  9. Mehta S, Hill NS. Non-invasive Ventilation.  Am J Respir Crit Care Med, 2001; 163: 540–577.
  10. Ramsay MAE, Savege TM, Simpson BRJ & Goodwin R. Controlled sedation with alpaxalone-alphadolone. British Medical Journal 1974; 2: 656 – 659
  11. Tobin MJ. Mechanical ventilation. N. Engl J Med 1994; 300:1056 -1061
  12. Barr J, Fraser GL, Puntillo K, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med. 2013; 41: 263-306.
  13. Tan JA, Ho KM. Use of dexmedetomidine as a sedative and analgesic agent in critically ill adult patients: a meta-analysis.  Intensive Care Med. 2010; 36: 926-39

Λέξεις Κλειδιά

ΜΕΘ, επεμβατικός, μη επεμβατικός αερισμός.

Προγράμματα ενδυνάμωσης και αντοχής αναπνευστικών μυών σε ασθενείς Μονάδας Εντατικής Θεραπείας υπό επεμβατικό μηχανικό αερισμό, ερευνητική τεκμηρίωση

Βιβλιογραφία

  1. Abelson H, Brewer K. Inspiratory muscle training in the mechanically ventilated patient. Physiotherapy Canada 1987; 39(5): 305-307.
  2. Aldrich T, Karpel J. Inspiratory muscle resistive training in respiratory failure. Am Rev Respir Dis 1985; 131: 461-462.
  3. Aldrich T, Uhrlass R. Weaning from mechanical Ventilation: Successful use of modified inspiratory resistive training in muscular dystrophy. Crit Care Med 1987; 15(3): 247-249.
  4. Aldrich T, Karpel J, Uhrlass R et al. Weaning from mechanical ventilation: Adjunctive use of inspiratory muscle resistive training. Crit Care Med 1989; 17(2): 143-147.
  5. The American Association for the Surgery of Trauma Mechnical Ventilation in the Intensive Care Unit. 2014. aast.org/.../mechanicalventilation.aspx
  6. Belman M. Respiratory failure treated by ventilatory muscle training. Eur J Respir Dis 1981; 62: 391-395.
  7. Bissett B, Ledetschke IA. Inspiratory muscle training to enhance weaning from mechanical ventilation. Anaesthesia and Intensive Care 2007; 35(5): 776-779.
  8. Bissett B, Leditchke IA. Paratz J.D., Boots R.J. Respiratory dysfunction in ventilated patients: can inspiratory muscle training help? Anaesth Intensive Care 2012; 40: 236-246.
  9. Bissett B, Leditschke IA., Green M. Specific inspiratory muscle training is safe in selected patients who are ventilator-dependent: a case series. Intensive Crit Care Nurs 2012; 28(2): 98-104.
  10. Boles J-M, Bion J, Connors A. Weaning from mechanical ventilation. Eur Respir J 2007; 29: 1033-1056.
  11. Cader S, Rodrigo Gomes de Souza Vale, Juracy Correa Castro et al. Inspiratory muscle training improves maximal inspiratory pressure and may assist weaning in order intubated patients: a randomised trial. Journal of Physiotherapy 2010; 56: 171-177.
  12. Cader S, Rodrigo Gomes de Souza Vale, Zamora V et al. Extubation process in bed-ridden eldery intensive care patients receiving inspiratory muscle training: a randomi Zed clinical trial. Clin Interv Aging 2012; 7: 437-443.
  13. Cader S, Vale R, Datas E. Effect of inspiratory muscle training on weaning success in critically ill intubated patients. 2013. http://cdu.intechopeu.com/pdfs/35007/In Tech-Effect_of_inspirator...
  14. Condessa R, Brauner J, Saul A et al. Inspiratory muscle training did not accelerate weaning from mechanical ventilation but did improve tidal volume and maximal respiratory pressures: a randomized trial. Journal of Physiotherapy 2013; 59: 101-107.
  15. Caruso P, Demari S, Ruiz S el al. Inspiratory muscle training is ineffective in mechanically ventilated critically ill patients clinics 2005; 60: 497-484.
  16. Crisafulli E, Costi St, Fabbri L, Clini E. Respiratory muscles training in COPD patients.Int J Chron Obstruct Pulmon Dis 2007; 2(1): 19-25.
  17. Gosselink R, Vos J. De, Heuvell SP. van den et al. Impact of inspiratory muscle training in patients with COPD: what is the evidence? Eur Respir J 2011; 37: 416-425.
  18. Γραμματοπούλου Ε, Τσάμης Ν, Ευαγγελοδήμου Α. Η εκπαίδευση των αναπνευστικών μυών στη Μ.Ε.Θ. Από 16ο Εντατική Θεραπεία και Επείγουσα Ιατρική: Ειδικές θεραπείες. Επιμέλεια Μπαλτόπουλος Γ. Σελ. 455-461. Κλινική Εντατικής Νοσηλείας Τμήματος Νοσηλευτικής Ε.Κ.Π.Α. Αθήνα 2013.
  19. Lermitte J, Garfield M. Weaning from mechanical ventilation. Contin Educ Anaesth Crit Care Pain 2005; 5(4): 113-117.
  20. Martin D, Davenport P, franceschi A, Harman E. Use of inspiratory muscle strength training to facilitate ventilator weaning. Chest 2002; 192-196.
  21. Moodie L, Reeve J, Vermeulen N, Elkins M. Inspiratory muscle training to facilitate weaning from mechanical ventilation: protocol for a systematic review. BMC Research Notes 2011; 4: 283 doi: 10.186/17 56-0500-4-283.
  22. Moodie L, Reeve J, Elkins M. Inspiratory muscle training increases inspiratory muscle strength in patients weaning from mechanical ventilation: a systematic review. Journal of Physiotherapy 2011; 57: 213-221.
  23. Μωραϊτου Φ. Μηχανική υποστήριξη της αναπνοής. Μ.Ε.Θ. – Π.Γ.Ν. ΝΙΚΑΙΑΣ www.exe1928.gr/.../cebccf89cf81ceb1ceb1ceb9cf84cebfcf85-cf86cebcceb7cf87cebdceb9cebaceb7
  24. Powers S, Kavazis A, Levine S. Prolonged mechanical ventilation alters diaphragmatic structure and function. Crit Care Med 2009; 37(10Suppl): S347-S353.
  25. Sobush D, Dunning M. Providing resistive breathing exercise to the inspiratory muscles using the PFLEXTM Phys Ther 1986; 66: 542-544.
  26. Sprague S, Hopkins P. Use of inspiratory strength training to wean six patients who were ventilator-dependent. Physical Therapy 2003; 83(2): 171-181.

Λέξεις Κλειδιά

ΜΕΘ, PImax, PEEP, Εξασκητές αναπνευστικών μυών, μηχανικός αερισμός, διασωλήνωση, τραχειοστομία, απογαλακτισμός, βαρέως πάσχοντες

Πρώιμη κινητοποίηση σε ασθενείς ΜΕΘ, είδη κινητοποίησης, προγράμματα βάδισης, ερευνητική τεκμηρίωση.

Βιβλιογραφία

  1. AARC Clinical Practice Guideline Nasotracheal Suctioning—2004 Revision & Update, RESPIRATORY CARE , 49(9):1080-4.
  2. Amanda J. Thomas Physiotherapy led early rehabilitation of the patient with critical illness.Physical Therapy Reviews, 2011; 16(1): 46-57.
  3. De Jonghe B, Lacherade J, Durand M, et al. Critical illness neuromuscular syndroms. Critical Care Clinics 2007; 23:55-69.
  4. Grigoriadis K, Efstathiou I, Petrianos I, Bakalidou D, Armaganidis A, Vasileiadis D. Improvement of patient’s ventilation by correcting the slid recumbent position In The ICU. The Internet Journal of Rehabilitation. 2010, DOI: 10.5580/1c98
  5. Gosselink R, Clerckx B, Robbeets C, Vanhullebusch T, Vanpee G, Segers J. Physiotherapy in the Intensive Care Unit. NETH J CRIT CARE  2011; 15(2): 66-75.
  6. Morris P. Moving Our Critically Ill Patients: Mobility Barriers and Benefits. Crit Care Clin 2007; 23:1–20.
  7. Schweickert, William D, Kress JP. "Implementing Early Mobilization Interventions in Mechanically Ventilated Patients in the ICU Early Mobilization in the ICU." CHEST 2011; 6:1612-1617.
  8. Stiller K, Phillips A. Safety aspects of mobilizing acutely ill inpatients. Physiother Theory Pract 2003; 19:239-257.
  9. Wagenmakers A. Muscle function in critically ill patients. Clin Nutr 2001; 20(5):451-4.
  10. Gosselink R, Bott J, Johnson M, Dean E, Nava S, Norrenberg M, et al. Physiotherapy for adults patients with critical illness: recommendations of the European respiratory society of intensive care medicine Task force on physiotherapy for critically ill patients. Intensive Care Medicine 2008; 34:1188-1199.
  11. Stevens RD, Dowdy DW, Michaels RK, et al. Neuromuscular dysfunction acquiered in critical illness: a systematic review. Intensive Care Medicine 2007; 33(11): 1876-1891.
  12. Martin UJ, Hincaple L, Nimchuk M, Gaughan, J, Criner G. Impact of whole-body rehabilitation in patients receiving chronic mechanical ventilation. Critical Care Medicine 2005; 33(10):2259-2265.
  13. Chiang L-L, Wang L-W, Wu C-P, Wu H-D, Wu Y-T. Effects of Physical Training on functional status in patients with prolonged mechanical ventilation. Physical Therapy, 86, 2006.
  14. Needham DM. Mobilizing patients in the intensive care unit-Improving neuromuscular weakness and physical function. JAMA 2008; 300: 1685-1690.

Λέξεις Κλειδιά

Μονάδα εντατικής θεραπείας, ορθοστάτηση, κινητοποίηση, βάδιση

Χειρουργική στεφανιαία αρτηριακή παράκαμψη (επαναιμάτωση μυοκαρδίου), χειρουργική αντικατάσταση καρδιακής/ών βαλβίδας/ων, συνδυασμός των προαναφερθέντων χειρουργείων, χειρουργική διόρθωση ανευρύσματος ανιούσης αορτής, χειρουργική αφαίρεση ανευρύσματος αριστερής κοιλίας, χειρουργική διόρθωση συγγενών καρδιοπαθειών ενηλίκων.

Βιβλιογραφία

  1. American Association of Cardiovascular and Pulmonary Rehabilitation/AACVPR. Chapter 2 “ Contemporary Revascularization Procedures, p.p. 11-25. In AACVPR Cardiac Rehabilitation Resource Manual 2006 Human Kinetics.
  2. American College of Cardiology Foundation/American Heart Association: 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery. Circulation. 2011; 124: 652-735.
  3. Cehalin L, La Pier TK, Shaw D: Sternal Precautions: Is it Time for Change? Precautions Versus Restrictions - A Review of Literature and Recommendations for Revision. Cardiopulm Phys Ther J. 2011; 22(1): 5-15.
  4. Hulzebos EHJ, Smit Y, Helders PPJM et al. Preoperative physical therapy for elective cardiac surgery patient. The Cochrane Collabration and published in th Cochrane Library 2012, Issue 11.
  5. Qiang Ji, Yunging Mei, Xisheng Wang et al. Risk Factors for Pulmonary Complications Following Cardiac Surgery with Cardio pulmonary Bypass. Int J Med Sci 2013; 10(11): 1578-1583.
  6. Makhabah DR, Martino F, Ambrosino N. Peri-operative physiotherapy. Multi disciplinary Respiratory Medicine 2013; 8: 4. http: //www.mmjournal.com/content/8/1/4
  7. Ridley S, Heinl-Green A. Chapter 12 “Surgery for adults”, p.p.377-423. In Physiotherapy for Respiratory and Cardiac Problems. Edited by Pryor J, Prasad SA. 2002, Churchill Livingstone.
  8. Wynne R, Botti M. Postoperative Pulmonary Dysfunction in Adults after Cardiac Surgery with Cardiopulmonary Bypass: Clinical Significance and Implications for Practice. Am I Crit Care, 2004; 13: 384-393.

Λέξεις Κλειδιά

Χειρουργείο στεφανιαίας παράκαμψης, ανευρίσματος, συγγενών καρδιοπαθειών ενηλίκων, αναπνευστική φυσικοθεραπεία, κινητοποίηση

Ανάλυση κλινικών περιστατικών ΜΕΘ και Χειρουργείων θώρακος-Κοιλίας (καρδιάς-πνευμονικού ιστού-άνω κοιλίας) αξιολόγηση, βραχυ-μακροπρόθεσμοι στόχοι, τεχνικές, ανατροφοδότηση, ερευνητική τεκμηρίωση.

Βιβλιογραφία

  1. Mackay MR, Ellis E, Johnston C. Randomized clinical trial of physiotherapy after open abdominal surgery in high risk patients. Australian Journal of Physiotherapy, 2005; 51:151–159.
  2. Fagevik Olsén M, Hahn I, Nordgren S, Lönroth H, LundholM K. Randomised controlled trial of prophylactic chest physiotherapy in major abdominal surgery. British Journal of Surgery 1997; 84:1535–1538.
  3. Manzano RM, Carvalho CR, Saraiva-Romanholo BM, et al. Chest physiotherapy during immediate postoperative period among patients undergoing upper abdominal surgery: A randomized clinical trial. Sao Paulo Medical Journal, 2008; 126(5):269-273.
  4. Stiller K, Phillips A. Safety aspects of mobilizing acutely ill inpatients. Physiother Theory Pract 2003; 19:239-257.
  5. Stiller K. Safety issues that should be considered when mobilizing critically ill patients. Critical care clinics, 2007; 23:35-53.
  6. Gosselink R, Bott J, Johnson M, Dean E, Nava S, Norrenberg M, et al. Physiotherapy for adults patients with critical illness: recommendations of the European respiratory society of intensive care medicine Task force on physiotherapy for critically ill patients. Intensive Care Medicine 2008; 34:1188-1199.
  7. Martin UJ, Hincaple L, Nimchuk M, Gaughan, J, Criner G. Impact of whole-body rehabilitation in patients receiving chronic mechanical ventilation. Critical Care Medicine 2005; 33(10):2259-2265.
  8. Sisson TH, Mendez M, Choi K, et al. Targeted injury of type II alveolar epithelial cells induces pulmonary fibrosis. Am J Respir Crit Care Med, 2010; 181:254 - 263.
  9. Spruit MA, Thomeer MJ, Gosselink R, et al. Skeletal muscle weakness in patients with sarcoidosis and its relationship with exercise intolerance and reduced health status. Thorax, 2005; 60: 32–38.
  10. Thomas JA, McIntosh JM. Are incentive spirometry, intermittent positive pressure breathing, and deep breathing exercises effective in the prevention of postoperative pulmonary complications after upper abdominal surgery? A Systematic Overview and Meta-analysis. Phys Ther, 1994; 74:3-10.
  11. Noppen M, de Keukeleire T. Pneumothorax. Respiration, 2008; 76 (2):121–7.
  12. Pasquina P, Tramer MR, Walder B. Prophylactic respiratory physiotherapy after cardiac surgery: Systematic review. BMJ, 2003; 327:1-6.
  13. Ince G, Sarpel T, Durgun B, et al. Effects of a Multimodal Exercise Program for people with Ankylosing Spondylitis. Phys Ther, 2006; 86:924-935.

Λέξεις Κλειδιά

Μονάδα εντατικής θεραπείας, περιοριστικές παθήσεις, χειρουργείο θώρακος, χειρουργείο καρδιάς.

Ανοικτό Ακαδ. Μάθημα

Ημερολόγιο

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