Purpose. To determine the effect of laser puncture on arterial blood gases for mechanically ventilated patients. Design. Single blind randomized controlled trial. Methods. Forty patients participated in the study, they were recruited from the critical care unit in Cairo University hospitals Kasr el Einy hospitals, Cairo, Egypt; their ages ranged from 50-70 years old, through a period of 33 months (from May 2016 to February 2019). Confidentiality was assured. They were assigned randomly into two groups equally in number; 20 patients each: Group (A) patients received both Laser puncture with an output of 5–20 mW, wavelength of 905 nm and frequency of 5000 Hz. laser probe stimulated on each point for 1 min, once daily for 10 days and routine intensive care physical therapy program twice per day. Group (B) patients received a routine intensive care physical therapy program (modified postural drainage, airway clearance techniques, lung expansion techniques and circulatory exercises for lower limbs) twice per day for 10 days. Pre and post Blood gas analysis for assessment of arterial blood gases (PaO2, PaCO2, O2%, and PaO2/FiO2) for all patients. Results. This study revealed improvement in PaO2/FiO2 in group (A), non significant change in PaO2, PaCO2 level, O2% after 10 days in both groups. Conclusion. Laser puncture had a significant effect in PaO2/FiO2, so this study supports the value of laser puncture on arterial blood gases for mechanically ventilated patients.
The aim of this study was to evaluate the effect of functional low frequency electrical stimulation of quadriceps and calf muscles on muscles strength and in patients with chronic heart failure (CHF). Methods: Fifty patients with chronic heart failure (CHF) were randomly selected from Cairo university hospital, their ages ranged from 40 to 60 years. They were divided into two groups, thirty patients for study group, and twenty patients for control group. Each patient in the study group received functional low frequency electrical stimulation with frequency 5 sessions per week for three successive weeks, in addition to medical treatment. Each patient of the control group received the same medical treatment, Pre and post study muscles strength assessment was done for each patient of both groups Results: The result of this study revealed statistically significant difference in muscles strength that showed a statistically significant improvement in patients for the study group in comparison to control group. Conclusion: Functional low frequency electrical stimulation of quadriceps and calf muscles improved muscles strength in patients with chronic heart failure, and offered an alternative training mode. Thus we recommended using functional low frequency electrical stimulation of quadriceps and calf muscles in order to improve muscles strength, reduce pain and swelling in patients with chronic heart failure.
Background: Unloading the diaphragm by mechanical ventilation results in diaphragmatic dysfunction and atrophy, a condition recognized in critical care settings as ventilator-induced diaphragmatic dysfunction (VIDD). This condition contributes to prolonged mechanical ventilation, extubation failure and higher risk of mortality. The aim of The Study:The current study aimed to investigate the effectiveness of inspiratory muscle training in preventing or reversing diaphragmatic atrophy in mechanically ventilated COVID-19 patients.Materials and Methods: 55 intubated, mechanically ventilated patients with hypoxic respiratory failure due to COVID-19 were randomly assigned into study (n = 32) and control (n = 23) groups. The former received inspiratory muscle training with the routine physiotherapy programme and the latter received routine physiotherapy only. Diaphragmatic thickness was measured and compared in both groups using ultrasonography.Results: In the study group, diaphragmatic thickness at end of inspiration and expiration significantly increased by 14% and 8% respectively (p < 0.001). The increase in thickness fraction for this group (7.5%) was statistically insignificant (p > 0.05). In the control group, there was a significant decrease in all three parameters (p < 0.001). Conclusion:Inspiratory muscle training by adjusting the ventilator's trigger sensitivity is a safe, effective and feasible method that can successfully prevent diaphragmatic atrophy in mechanically ventilated, COVID-19 patients.
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