The Effect of Semi-recumbent Position With Exercise Training on Long-term Ventilator-dependent Patients
Condition: Mechanical Ventilation; Difficult Intubation; Position; Exercise
Study type: Interventional

Summary: 
      Prolonged mechanical ventilation patients rely on medical expenses per year had increased by
      nearly 20 billion in 15 years, so it is worthwhile to explore how to improve the respiratory
      function and even their quality of life of patients in Respiratory care wards (RCWs). This
      study used repeated experimental measurements and purpose sampling, and the investigators
      invited patients in respiratory care ward in northern Taiwan. They were randomly assigned to
      the experimental group and the control group. The experimental group was given 45 degree
      Semi-sitting 2 hrs and upper-limb exercise training 10 mins once a day. There were 29
      prolonged mechanical ventilation (PMV) patients in the experimental group and 26 in the
      control group. Our conclusions showed that PMV patients can significantly improve the maximum
      inspiratory pressure (MIP) in the post-test while performed a 45-degree semi-sitting position
      with upper limb training for 4 weeks. The minute ventilation (MV) has a trend of increasing
      month by month in the experimental group, but it is necessary to consider whether it is due
      to the improvement of lung function or just cause of the increased oxygen consumption and
      accelerated respiratory rate, so it can not be inferred to improvement of the patient's
      condition or lung function.
    

Detailed description: 
      Background: Prolonged mechanical ventilation patients rely on medical expenses per year had
      increased by nearly 20 billion in 15 years. However, the high cost shows the high morbidity
      rate, high mortality rate and low ventilator weaning rate of prolonged mechanical ventilation
      patients, so it is worthwhile to explore how to improve the respiratory function and even
      their quality of life of patients in the respiratory care ward (RCW).

      OBJECTIVE: To investigate the improvement of respiratory function and the effect of
      respirator detachment in 45-degree semi-sitting and upper limb training, and to understand
      the correlation between this training activity and death risk.

      METHODS: This study used repeated experimental measurements and purpose sampling, and the
      investigators invited patients in the respiratory care ward (RCW) in northern Taiwan. They
      were randomly assigned to the experimental group and the control group. The experimental
      group was given 45 degree Semi-sitting 2hrs and upper-limb exercise training 10mins once a
      day. After 4 weeks, the investigators measure the respiratory parameters such as the maximum
      inspiratory pressure (MIP), the tidal volume (VT), the minute ventilation (MV), and the rapid
      shallow breathing index(RSBI) of these two groups, and used the generalized estimating
      equation (GEE) to compare with them.
    

Intervention name(s): 45 Degree Semi-recumbent Position With Upper Limb Exercise Training; no 45 Degree Semi-recumbent Position With Upper Limb Exercise Training
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The experimental group was given 45 degree Semi-sitting 2 hrs and upper-limb exercise training 10 mins once a day, and this intervention kept 4 weeks.; The control group was with usual treatment.
Other intervention name(s): 45 Degree Semi-sitting Position With Upper Limb Exercise Training; no other intervention
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: This study used repeated experimental measurements and purpose sampling, and we invited patients in respiratory care ward (RCW) in northern Taiwan. They were randomly assigned to the experimental group and the control group. The experimental group was given 45 degree Semi-sitting for 2hrs and upper-limb exercise training 10mins once a day. The control group was just continue the routine treatment. After 4 weeks, we measure the respiratory parameters such as maximum inspiratory pressure (MIP), tidal volume (VT), minute ventilation (MV), and rapid shallow breathing index(RSBI) of these two groups, and used GEE to compare with them. To find the differences in respiratory parameters, ventilator detachment rate,
Masking: Single (Participant)
Primary purpose: Treatment