下肢彈性繃帶包紮對「重症呼吸器病人持續性鎮靜治療 低血壓發生的預防成效

Abstract

This study evaluated how wrapping the limbs with elastic bandages affects mean blood pressure (MBP), central venous pressure (CVP) and skin integrity of continuously sedated and ventilated ICU patients. A randomized controlled study was conducted in a 42-bed medical and surgical ICU in a medical center. Ninety patients were recruited and randomly assigned to an experimental group (forty-three patients with elastic bandage) and a control group (forty-seven patients without elastic bandage). Data for MBP, CVP and skin integrity were collected at the time of intervention (application of bandage), drug (propofol, dormicum) loading phase, maintenance phase, +5 min, +10 min, +15 min, +30 min, +1 hr, +2 hr, +4 hr, +8 hr, and 5 min and 30 min after bandage removal. Total 13 points of observations. The experimental results demonstrated that MBP in the control group was significantly lower than in the experimental group at the time of drug loading phase (p=0.04), after drug maintenance phase +10 min (p=0.04), +2 hr (p＜0.00) and 5 min after bandage removal (p=0.04). The ratio of blood pressure change (observation point blood pressure-pre-intervention blood pressure) significantly differed between the experimental group [0.17 mmHg (± 23.50)] and the control group [9.43 mmHg (± 20.95)], (p=0.046, 95% C.I.-19.04~-0.18) 2 hr after drug administration. The groups did not significantly differ in CVP effects or skin integrity. In conclusion, the elastic bandage is useful for preventing the effects of sedative agents on MBP.