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Physical therapy in icu

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https://www.readbyqxmd.com/read/29747662/progressive-mobility-program-and-technology-to-increase-the-level-of-physical-activity-and-its-benefits-in-respiratory-muscular-system-and-functionality-of-icu-patients-study-protocol-for-a-randomized-controlled-trial
#1
Debora Stripari Schujmann, Adriana Claudia Lunardi, Carolina Fu
BACKGROUND: Enhanced mobility in the Intensive Care Unit (ICU) could minimize the negative effects of critical illness, such as declines in cognitive, muscular, respiratory, and functional capacity. We aim to compare the functional status at ICU discharge of patients who underwent a progressive mobilization protocol versus patients who received conventional physiotherapy. We also examine the level of physical activity in the ICU, the degree of pulmonary and muscle function, and the length of stay to analyze correlations between these variables...
May 10, 2018: Trials
https://www.readbyqxmd.com/read/29747562/early-ambulation-in-patients-with-external-ventricular-drains-results-of-a-quality-improvement-project
#2
Syed Omar Shah, Jacqueline Kraft, Nethra Ankam, Paula Bu, Kristen Stout, Sara Melnyk, Fred Rincon, M Kamran Athar
INTRODUCTION: Prolonged immobility in patients in the intensive care unit (ICU) can lead to muscle wasting and weakness, longer hospital stays, increased number of days in restraints, and hospital-acquired infections. Increasing evidence demonstrates the safety and feasibility of early mobilization in the ICU. However, there is a lack of evidence in the safety and feasibility of mobilizing patients with external ventricular drains (EVDs). The purpose of this study was to determine the safety and feasibility of early mobility in this patient population...
June 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29694610/bronchial-hygiene-techniques-in-patients-on-mechanical-ventilation-what-are-used-and-why
#3
Isabela Naiara Evangelista Matilde, Raquel Afonso Caserta Eid, Andréia Ferreira Nunes, Alexandre Ricardo Pepe Ambrozin, Renata Henn Moura, Denise Carnieli-Cazati, Karina Tavares Timenetsky
Objective To analyze and describe the maneuvers most commonly used in clinical practice by physical therapists and the reasons for choosing them. Methods A prospective multicenter study using a questionnaire. The sample consisted of physical therapists from five hospitals (three private hospitals, a teaching hospital and a public hospital). Results A total of 185 questionnaires were filled in. Most professionals had graduated 6 to 10 years before and over had over 10 years of intensive care unit experience...
2018: Einstein
https://www.readbyqxmd.com/read/29668026/nicu-graduates-the-role-of-the-allied-health-team-in-follow-up
#4
Jane L Orton, Joy E Olsen, Katherine Ong, Rochelle Lester, Alicia J Spittle
Infants who graduate from the neonatal intensive care unit, including those infants born preterm and/or with brain injury, are at increased risk of long-term neurodevelopmental impairments. The developmental allied health team, consisting of physical therapy, occupational therapy, and speech pathology, is crucial in early evaluation of gross motor, fine motor, feeding, and language development. Surveillance of neurodevelopment in the first year of life is essential to ensure early detection of specific developmental delays and impairments, and to ensure timely referral for early intervention...
April 1, 2018: Pediatric Annals
https://www.readbyqxmd.com/read/29666075/rogue-one-a-story-of-tophaceous-gout-in-the-spine
#5
Karthik Dwarki, Andy Dothard, Bryan Abadie, Matthew C Miles
A 26-year-old man with history of extensive tophaceous gout presented to the referring facility with decreased bilateral lower extremity sensation and motor function that began acutely 1 week prior to admission and had progressed to urinary incontinence. The patient was admitted to the intensive care unit due to concern for sepsis secondary to epidural abscess. The patient was started on empiric vancomycin and cefepime. Neurosurgery did not recommend acute neurosurgical intervention given the lack of a compressive lesion...
April 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29582429/early-intervention-mobilization-or-active-exercise-for-critically-ill-adults-in-the-intensive-care-unit
#6
REVIEW
Katherine A Doiron, Tammy C Hoffmann, Elaine M Beller
BACKGROUND: Survivors of critical illness often experience a multitude of problems that begin in the intensive care unit (ICU) or present and continue after discharge. These can include muscle weakness, cognitive impairments, psychological difficulties, reduced physical function such as in activities of daily living (ADLs), and decreased quality of life. Early interventions such as mobilizations or active exercise, or both, may diminish the impact of the sequelae of critical illness. OBJECTIVES: To assess the effects of early intervention (mobilization or active exercise), commenced in the ICU, provided to critically ill adults either during or after the mechanical ventilation period, compared with delayed exercise or usual care, on improving physical function or performance, muscle strength and health-related quality of life...
March 27, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29564277/the-effect-of-positional-changes-on-oxygenation-in-patients-with-head-injury-in-the-intensive-care-unit
#7
Jigar Nayankumar Mehta, Lata D Parmar
Background: Following head injury, cardiopulmonary functions are impaired and this disturbs the oxygenation transport pathway. Expanding cardiopulmonary physical therapy to encompass the oxygen transport system as a whole has implication for treatment as well as assessment and treatment outcome. Therefore, the aim of the study is to assess the oxygenation level in head injury patients with relation to body positioning in the intensive care unit (ICU). Methodology: Thirty consecutive patients with head injury with hemodynamically stable were included from the surgical ICU, ages ranging from 15 to 50 years...
October 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29559375/contemporary-outcomes-of-ecmo-used-as-bridge-to-lung-transplantation
#8
Ali H Hakim, Usman Ahmad, Kenneth R McCurry, Douglas R Johnston, Gosta B Pettersson, Marie Budev, Sudish Murthy, Eugene H Blackstone, Michael Z Tong
BACKGROUND: Extracorporeal membrane oxygenation (ECMO), when used as bridge to lung transplantation (BTT) identifies high-risk candidates. Recent advances in cannula design and patient selection fosters "awake ambulatory ECMO" as a viable option for critically ill candidates in an attempt to retard deconditioning while awaiting allografts. METHODS: From 2012 to 2015, 30 patients underwent ECMO as BTT. Candidacy for ECMO was determined prior to listing for transplant...
March 17, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29559356/alpha-lipoic-acid-intoxicat%C3%A4-on-an-adult-case-report-and-l%C3%A4-terature-rev%C3%A4-ew
#9
Duygu Ferek Emir, Ibrahim Ulas Ozturan, Serkan Yilmaz
INTRODUCTION: Alpha lipoic acid (ALA) is a potent antioxidant used to treat a variety of disorders. Although ALA is considered a very safe supplement and intoxication is very rare, acute high-dose ingestions can cause mortality. In this report, we discuss a very rare case of ALA intoxication to increase awareness of this issue. CASE REPORT: A 22-year-old female was referred to our emergency department with ALA intoxication after ingesting a total of 18g of ALA with a suicidal intention...
March 13, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29552425/clinician-driven-design-of-vitalpad-an-intelligent-monitoring-and-communication-device-to-improve-patient-safety-in-the-intensive-care-unit
#10
Luisa Flohr, Shaylene Beaudry, K Taneille Johnson, Nicholas West, Catherine M Burns, J Mark Ansermino, Guy A Dumont, David Wensley, Peter Skippen, Matthias Gorges
The pediatric intensive care unit (ICU) is a complex environment, in which a multidisciplinary team of clinicians (registered nurses, respiratory therapists, and physicians) continually observe and evaluate patient information. Data are provided by multiple, and often physically separated sources, cognitive workload is high, and team communication can be challenging. Our aim is to combine information from multiple monitoring and therapeutic devices in a mobile application, the VitalPAD , to improve the efficiency of clinical decision-making, communication, and thereby patient safety...
2018: IEEE Journal of Translational Engineering in Health and Medicine
https://www.readbyqxmd.com/read/29530090/adherence-to-standardized-assessments-through-a-complexity-based-model-for-categorizing-rehabilitation%C3%A2-design-and-implementation-in-an-acute-hospital
#11
Tania Gutiérrez Panchana, Viviane Hidalgo Cabalín
BACKGROUND: The use of measurement instruments has become a major issue in physical therapy, but their use in daily practice is rare. The aim of this paper is to describe adherence to standardized assessments by physical therapists using a complexity-based model for categorizing rehabilitation (CMCR) at the Clínica Alemana of Santiago, an acute hospital in Chile. METHODS: This retrospective cohort study used 145,968 participant records that were stored in the inpatient database between July 2011 and December 2015...
March 12, 2018: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29508894/discharge-prescribing-of-enteral-opioids-after-initiation-as-a-weaning-strategy-from-continuous-opioid-infusions-in-the-intensive-care-unit
#12
Bridgette Kram, Kylie M Weigel, Michelle Kuhrt, Daniel L Gilstrap
OBJECTIVE: To evaluate the proportion of patients receiving a hospital discharge prescription for a scheduled enteral opioid following initiation as a weaning strategy from a continuous opioid infusion in the Intensive Care Unit (ICU). DESIGN: Retrospective, observational study. SETTING: Five adult ICUs at a large, quaternary care academic medical center. PATIENTS: Endotracheally intubated, opioid-naive adults receiving a continuous opioid infusion with a concomitant scheduled enteral opioid initiated...
January 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29502930/a-comparison-of-compliance-in-the-estimation-of-body-fluid-status-using-daily-fluid-balance-charting-and-body-weight-changes-during-continuous-renal-replacement-therapy
#13
Hugh Davies, Gavin D Leslie, David Morgan, Geoff J Dobb
BACKGROUND: The risk of fluid overload and mortality is increased in patients with severe acute kidney injury. Charting of daily fluid balance is a key component of fluid assessment but not without problems affecting accuracy. The introduction of electronic bed scales has made routine patient-weighing easier and focused attention on monitoring fluid-related weight changes. OBJECTIVES: This paper investigated the frequency of compliance in weighing patients daily using electronic bed scales and evaluated the relationship between calculated fluid balance and body weight changes in patients receiving continuous renal replacement therapy (CRRT)...
March 1, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29474555/health-related-quality-of-life-of-patients-after-surgery-for-acute-type-a-aortic-dissection
#14
Uyanga Adam, Helmut Habazettl, Katharina Graefe, Hermann Kuppe, Maximilian Wundram, Stephan Dominik Kurz
OBJECTIVES: Acute Type A aortic dissection (ATAAD) and the ensuing surgical therapy may be experienced as a traumatic event by patients. This study aimed at analysing the prevalence of post-traumatic stress disorder (PTSD) and the physical and mental well-being of survivors of surgically treated ATAAD. METHODS: A total of 393 survivors were contacted and asked to fill in various health questionnaires. RESULTS: Two hundred and ten (53%) patients returned the questionnaires...
February 20, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29468104/cerebellar-stroke-occupational-therapy-and-physical-therapy-management-from-intensive-care-unit-to-outpatient-a-case-report
#15
Christopher M Wilson, Christina L Mitchell, Katherine M Hebert
Cerebellar stroke increases the risk of extensive physical disability and long-term institutionalization. The purpose of this case report is to describe the 14-month longitudinal rehabilitation management and outcomes from the intensive care unit, inpatient rehabilitation unit and outpatient care of a patient after cerebellar stroke. A goal of this case report is to provide rehabilitation clinicians with a long-term perspective and understanding of the course of recovery for a patient after cerebellar cerebrovascular accident or related injury...
December 14, 2017: Curēus
https://www.readbyqxmd.com/read/29430447/mechanisms-involved-in-brain-dysfunction-in-mechanically-ventilated-critically-ill-patients-implications-and-therapeutics
#16
REVIEW
Marc Turon, Sol Fernández-Gonzalo, Candelaria de Haro, Rudys Magrans, Josefina López-Aguilar, Lluís Blanch
Critical illness may lead to significant long-term neurological morbidity and patients frequently develop neuropsychological disturbances including acute delirium or memory impairment after intensive care unit (ICU) discharge. Mechanical ventilation (MV) is a risk factor to the development of adverse neurocognitive outcomes. Patients undergoing MV for long periods present neurologic impairment with memory and cognitive alteration. Delirium is considered an acute form of brain dysfunction and its prevalence rises in mechanically ventilated patients...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29419665/the-effects-of-physical-therapy-with-neuromuscular-electrical-stimulation-in-patients-with-septic-shock-study-protocol-for-a-randomized-cross-over-design
#17
RANDOMIZED CONTROLLED TRIAL
Alessandra Fabiane Lago, Anamaria Siriani de Oliveira, Hugo Celso Dutra de Souza, João Santana da Silva, Anibal Basile-Filho, Ada Clarice Gastaldi
INTRODUCTION: Septic shock is a potentially fatal organ dysfunction caused by an imbalance of the host response to infection. The changes in microcirculation during sepsis can be explained by the alterations in the endothelial barrier function. Endothelial progenitor cells (EPCs) are a potential recovery index of endothelial function and it an increase in response to neuromuscular electrical stimulation (NMES) was demonstrated. Therefore, the objective of this study is to investigate the effects of NMES in patients with septic shock...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29374645/spontaneous-calf-haematoma-in-severe-dengue
#18
Ahmad Mursel Anam, Raihan Rabbani, Farzana Shumy
We report a case of spontaneous calf muscle haematoma, formed during the recovery phase of dengue haemorrhagic fever, which, to the best of our knowledge, has never been encountered before. A 45-year-old man presented with features of severe dengue and got admitted to our intensive care unit. He was treated with intravenous fluid therapy and supportive measures, and gradually improved, initially. However, during the recovery phase, he suddenly developed painful left calf, which was found tender, hot and swollen on physical examination...
January 26, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29298407/a-hybrid-form-of-telemedicine-a-unique-way-to-extend-intensive-care-service-to-neonates-in-medically-underserved-areas
#19
Abhishek Makkar, Mike McCoy, Gene Hallford, Marilyn Escobedo, Edgardo Szyld
BACKGROUND: More than 90% of neonatal intensive care units (NICUs) in the United States are in urban areas, denying rural residents' easy NICU access. Telemedicine use for patient contact and management, although studied in adults and children, is understudied in neonates. A hybrid telemedicine system, with 24/7 neonatal nurse practitioner coverage and with a neonatologist physically present 3 days per week and telemedicine coverage the remaining days, was recently implemented at Comanche County Memorial Hospital's (CCMH) Level II NICU...
January 3, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29242519/timing-and-amount-of-physical-therapy-treatment-are-associated-with-length-of-stay-in-the-cardiothoracic-icu
#20
Audrey M Johnson, Angela N Henning, Peter E Morris, Alejandro G Villasante Tezanos, Esther E Dupont-Versteegden
Significant variability exists in physical therapy early mobilization practice. The frequency of physical therapy or early mobilization of patients in the cardiothoracic intensive care unit and its effect on length of stay has not been investigated. The goal of our research was to examine variables that influence physical therapy evaluation and treatment in the intensive care unit using a retrospective chart review. Patients (n = 2568) were categorized and compared based on the most common diagnoses or surgical procedures...
December 14, 2017: Scientific Reports
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