AUTHOR=Sun Jianhua , Cui Na , Han Wen , Li Qi , Wang Hao , Li Zunzhu , Cheng Wei , Luo Hongbo , Zhao Mingxi 

TITLE=Implementation of Nurse-Led, Goal-Directed Lung Physiotherapy for Older Patients With Sepsis and Pneumonia in the ICU

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.753620

DOI=10.3389/fmed.2021.753620

ISSN=2296-858X

ABSTRACT=<p><bold>Objectives:</bold> This study aimed to investigate the effect of nurse-led, goal-directed lung physiotherapy (GDLPT) on the prognosis of older patients with sepsis caused by pneumonia in the intensive care unit.</p><p><bold>Methods:</bold> We conducted a prospective, two-phase (before-and-after) study over 3 years called the GDLPT study. All patients received standard lung therapy for sepsis caused by pneumonia and patients in phase 2 also received GDLPT. In this study, 253 older patients (age ≥ 65 years) with sepsis and pneumonia were retrospectively analyzed. The main outcome was 28 day mortality.</p><p><bold>Results:</bold> Among 742 patients with sepsis, 253 older patients with pneumonia were divided into the control group and the treatment group. Patients in the treatment group had a significantly shorter duration of mechanical ventilation [5 (4, 6) vs. 5 (4, 8) days; <italic>P</italic> = 0.045], and a lower risk of intensive care unit (ICU) mortality [14.5% (24/166) vs. 28.7% (25/87); <italic>P</italic> = 0.008] and 28 day mortality [15.1% (25/166) vs. 31% (27/87); <italic>P</italic> = 0.005] compared with those in the control group. GDLPT was an independent risk factor for 28 day mortality [odds ratio (OR), 0.379; 95% confidence interval (CI), 0.187–0.766; <italic>P</italic> = 0.007].</p><p><bold>Conclusions:</bold> Nurse-led GDLPT shortens the duration of mechanical ventilation, decreases ICU and 28-day mortality, and improves the prognosis of older patients with sepsis and pneumonia in the ICU.</p>