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=Volume 8 - 2021

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=Objectives: 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.
Methods: 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.
Results: 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; P=0.045), and a lower risk of intensive care unit (ICU) mortality (14.5% [24/166] vs 28.7% [25/87]; P=0.008) and 28-day mortality (15.1% [25/166] vs 31% [27/87]; P=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; P=0.007).
Conclusions: 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.