Original Article

Effect of Early Multidisciplinary Collaboration Combined with Cluster Strategy on Acquired Debilitating Syndrome in ICU of Patients with Acute Myocardial Infarction

Abstract

Background: To investigate the preventive effect of early multidisciplinary collaboration combined with cluster strategy on acquired frailty syndrome in ICU of patients with acute myocardial infarction (AMI).

Methods: A total of 240 patients with myocardial infarction (MI) admitted to ICU in The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar, China from March 2018 to March 2020 were selected. The patients were randomly divided into experiment group and control group equally according to random number method. The experimental group was treated with early multidisciplinary collaboration and cluster strategy, while the control group was treated with routine nursing mode. Duration of ventilation, total length of stay, length of ICU stay, New York College of Cardiology cardiac function classification, MRC-Score, BI and complications during hospitalization were recorded.

Results: After intervention, there were statistically significant differences in ventilation duration, total length of stay, length of stay in ICU, Heart function classification of New York Cardiology Society, MRC-Score, BI index, SF-36 score and complications during hospitalization in 2 groups (P < 0.05), and the above indicators in the experimental group were better than those in the control group.

Conclusion: Early multidisciplinary collaboration combined with cluster strategy can significantly reduce the incidence of AMI in ICU of MI patients.

1. Zorowitz RD (2016). ICU-acquir ed weak-ness：a rehabilitation perspective of di-agnosis, treatment, and functional man-agement. Chest, 150(4): 966-971.
2. Fan E, Cheek F, Chlan L, et al (2014). An official American Thoracic Society Clinical Practice Guideline：the diagnosis of in-tensive care unit-acquired weakness in adult. Am J Respir Crit Care Med, 190(12): 1437-1446.
3. Puri VGA (2016). Weakness in the critically ill: can we predict and prevent? Neurol In-dia, 64(4): 606-607.
4. Witteveen E, Wieske L, Verhamme C, Schultz MJ, van Schaik IN, Horn J (2014). Muscle and nerve inflammation in inten-sive care unit-acquired weakness: A sys-tematic translational review. J Neurol Sci, 345(1-2): 15-25.
5. Bakhru RN, McWilliams DJ, Wiebe DJ, Spuhler VJ, Schweickert WD (2016). In-tensive care unit structure variation and implications for early mobilization prac-tices. An international survey. Ann Am Thorac Soc, 13(9): 1527-1537.
6. Wang Q, Qian SY (2014). The assessment of sedation and analgesia in critical chil-dren. Chin Pediatr Emerg Med, 21(2): 79-83.
7. Balas MC, Vasilevskis EE, Burke WJ, et al (2012). Critical care nurses role in imple-menting the ABCDE Bundle into prac-tice. Grit Care Nur, 32(2): 35-47．
8. Knaus WA, Zimmerman JE, Wagner DP, Draper EA, Lawrence DE (1981). APACHE acute physiology and chronic health evaluation:a physiologically based classification system. Crit Care Med, 9(8): 591-597.
9. Stevens RD, Marshall SA, Cornblath DR, et al (2009). A framework for diagnosing and classifying intensive care unit-acquired weakness. Crit Care Med, 37(10 Suppl): S299-308.
10. Buurman BM, van Munster BC, Korevaar JC, de Haan RJ, de Rooij SE (2011). Vari-ability in measuring(instrumental)activities of daily living functioning and functional decline in hospitalized older medical pa-tients: a systematic review. J Clin Epidemi-ol,64(6):619-627.
11. Fink H, Helming M, Unterbuchner C, Lenz A, Neff F, Martyn JA, Blobner M (2008). Systemic inflammatory response syn-drome increases immobility-induced neu-romuscular weakness. Crit Care Med, 36 (3): 910-16.
12. Grosu HB, Lee YI, Lee J, Eden E, Eiker-mann M, Rose KM (2012). Diaphragm muscle thinning in patients who are me-chanically ventilated. Chest, 142 (6): 1455-1460.
13. Schweickert WD, Pohlman MC, Pohlman AS, et al (2009). Early physical and occu-pational therapy in mechanically ventilat-ed, critically ill patients: a randomised controlled trial. Lancet, 373(9678): 1874-82.
14. Morandi A, Brummel NE, Ely EW (2011). Sedation, delirium and mechanical ventila-tion: the 'ABCDE' approach. Curr Opin Crit Care, 17(1): 43-9.
15. Vasilevskis EE, Ely EW, Speroff T, Pun BT, Boehm L, Dittus RS (2010). Reducing iat-rogenic risks: ICU-acquired delirium and weakness--crossing the quality chasm. Chest, 138(5): 1224-33.
16. Mart MF, Pun BT, Pandharipande P, Jack-son JC, Ely EW (2021). ICU Survivor-ship-The Relationship of Delirium, Seda-tion, Dementia, and Acquired Weakness. Crit Care Med, 49(8): 1227-1240.
17. Kress JP, Pohlman AS, O'Connor MF, Hall JB (2000). Daily interruption of sedative infusions in critically ill patients undergo-ing mechanical ventilation. N Engl J Med, 342(20): 1471- 1477.
18. Wu Q, Jiang ZX, Pan YB, et al (2018). Anal-ysis of risk fac tors of delirium in patients with mechanical ventilation in intensive care unit. Chin J Nurs, 53(5): 543-548.
19. Azzam MA, Elngar EF, Shimaa A, et al (2019). Daily sedation interruption versus routine sedation in critically ill children：a systematic review and meta-analysis. Egypt J Anaesth, 35(1): 71-79.
20. Rodriguez PO, Setten M, Maskin LP, et al (2012). Muscle weakness in septic patients requiring mechanical ventilation: Protec-tive effect of transcutaneous neuromus-cular electrical stimulation. J Crit Care, 27(3): 319.e1-8.
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IssueVol 51 No 11 (2022) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijph.v51i11.11169
Keywords
Acute myocardial infarction Multidisciplinary collaboration Bunching strategy
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How to Cite
1.
Zhao T, Zhao M, Li Q, Guan Z, Zhang X, Li L. Effect of Early Multidisciplinary Collaboration Combined with Cluster Strategy on Acquired Debilitating Syndrome in ICU of Patients with Acute Myocardial Infarction. Iran J Public Health. 2022;51(11):2519-2527.