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Rehabilitation critical illness

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https://www.readbyqxmd.com/read/29054691/impact-of-critical-illness-polyneuromyopathy-in-rehabilitation-a-prospective-observational-study
#1
Cameron Cunningham, Heather C Finlayson, William R Henderson, Russell J O'Connor, Andrew Travlos
BACKGROUND: Critical illness polyneuromyopathy (CIPNM) is increasingly recognized as a source of disability in patients requiring intensive care unit (ICU) admission. The prevalence and impact of CIPNM on patients in the rehabilitation setting has not been established. OBJECTIVES: To determine the proportion of at-risk rehabilitation inpatients with evidence of CIPNM and the functional sequelae of this disorder. DESIGN: Prospective observational study...
October 17, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28991149/decisional-informatics-for-psychosocial-rehabilitation-a-feasibility-pilot-on-tailored-and-fluid-treatment-algorithms-for-serious-mental-illness
#2
Jimmy Choi, Paul H Lysaker, Morris D Bell, Lisa Dixon, Paul Margolies, Matthew Gold, Elizabeth Golden-Roose, Warren Thime, Lawrence C Haber, Michael J Dewberry, Michael Stevens, Godfrey D Pearlson, Joanna M Fiszdon
This study introduces a computerized clinical decision-support tool, the Fluid Outpatient Rehabilitation Treatment (FORT), that incorporates individual and ever-evolving patient needs to guide clinicians in developing and updating treatment decisions in real-time. In this proof-of-concept feasibility pilot, FORT was compared against traditional treatment planning using similar behavioral therapies in 52 adults with severe mental illness attending community-based day treatment. At posttreatment and follow-up, group differences and moderate-to-large effect sizes favoring FORT were detected in social function, work readiness, self-esteem, working memory, processing speed, and mental flexibility...
October 4, 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/28978333/evaluating-physical-functioning-in-critical-care-considerations-for-clinical-practice-and-research
#3
Selina M Parry, Minxuan Huang, Dale M Needham
The evaluation of physical functioning is valuable in the intensive care unit (ICU) to help inform patient recovery after critical illness, to identify patients who may require rehabilitation interventions, and to monitor responsiveness to such interventions. This viewpoint article discusses: (1) the concept of physical functioning with reference to the World Health Organization International Classification of Functioning, Disability and Health; (2) the importance of measuring physical functioning in the ICU; and (3) methods for evaluating physical functioning in the ICU...
October 4, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28930814/neurologic-and-functional-morbidity-in-critically-ill-children-with-bronchiolitis
#4
Steven L Shein, Katherine N Slain, Jason A Clayton, Bryan McKee, Alexandre T Rotta, Deanne Wilson-Costello
OBJECTIVES: Neurologic and functional morbidity occurs in ~30% of PICU survivors, and young children may be at particular risk. Bronchiolitis is a common indication for PICU admission among children less than 2 years old. Two single-center studies suggest that greater than 10-25% of critical bronchiolitis survivors have neurologic and functional morbidity but those estimates are 20 years old. We aimed to estimate the burden of neurologic and functional morbidity among more recent bronchiolitis patients using two large, multicenter databases...
September 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28930813/temporal-changes-in-prescription-of-neuropharmacologic-drugs-and-utilization-of-resources-related-to-neurologic-morbidity-in-mechanically-ventilated-children-with-bronchiolitis
#5
Steven L Shein, Katherine Slain, Deanne Wilson-Costello, Bryan McKee, Alexandre T Rotta
OBJECTIVES: Critically ill children with bronchiolitis may require neuropharmacologic medications and support for neuro-functional sequelae, but current practices are not well described. We aimed to describe recent trends in neuropharmacology and utilization of neuro-rehabilitation resources in mechanically ventilated children with bronchiolitis. DESIGN: Analysis of the multicenter Pediatric Health Information System database. SETTING: Forty-seven U...
September 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28837430/the-epidemiology-of-chronic-critical-illness-after-severe-traumatic-injury-at-two-level-one-trauma-centers
#6
Juan C Mira, Joseph Cuschieri, Tezcan Ozrazgat-Baslanti, Zhongkai Wang, Gabriela L Ghita, Tyler J Loftus, Julie A Stortz, Steven L Raymond, Jennifer D Lanz, Laura V Hennessy, Babette Brumback, Philip A Efron, Henry V Baker, Frederick A Moore, Ronald V Maier, Lyle L Moldawer, Scott C Brakenridge
OBJECTIVE: To determine the incidence and risk factors of chronic critical illness after severe blunt trauma. DESIGN: Prospective observational cohort study (NCT01810328). SETTING: Two-level one trauma centers in the United States. PATIENTS: One hundred thirty-five adult blunt trauma patients with hemorrhagic shock who survived beyond 48 hours after injury. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Chronic critical illness was defined as an ICU stay lasting 14 days or more with evidence of persistent organ dysfunction...
August 23, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28820799/regional-anesthesia-and-analgesia-after-surgery-in-icu
#7
Mathieu Capdevila, Séverin Ramin, Xavier Capdevila
PURPOSE OF REVIEW: The aim is to demonstrate that ICU physicians should play a pivotal role in developing regional anesthesia techniques that are underused in critically ill patients despite the proven facts in perioperative and long-term pain, organ dysfunction, and postsurgery patient health-related quality of life improvement. RECENT FINDINGS: Regional anesthesia and/or analgesia strategies in ICU reduce the surgical and trauma-stress response in surgical patients as well as complications incidence...
October 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28814998/correction-to-tsavourelou-a-stylianides-n-papadopoulos-a-dikaiakos-m-d-nanas-s-kyprianou-t-tokmakidis-s-p-2016-telerehabilitation-solution-conceptual-paper-for-community-based-exercise-rehabilitation-of-patients-discharged-after-critical-illness-international
#8
https://www.readbyqxmd.com/read/28780504/intensive-versus-standard-physical-rehabilitation-therapy-in-the-critically-ill-epicc-a-multicentre-parallel-group-randomised-controlled-trial
#9
Stephen E Wright, Kirsty Thomas, Gillian Watson, Catherine Baker, Andrew Bryant, Thomas J Chadwick, Jing Shen, Ruth Wood, Jennifer Wilkinson, Leigh Mansfield, Victoria Stafford, Clare Wade, Julie Furneval, Andrea Henderson, Keith Hugill, Philip Howard, Alistair Roy, Stephen Bonner, Simon Baudouin
BACKGROUND: Early physical rehabilitation in the intensive care unit (ICU) has been shown to improve short-term clinical outcomes but long-term benefit has not been proven and the optimum intensity of rehabilitation is not known. METHODS: We conducted a randomised, parallel-group, allocation-concealed, assessor-blinded, controlled trial in patients who had received at least 48 hours of invasive or non-invasive ventilation. Participants were randomised in a 1:1 ratio, stratified by admitting ICU, admission type and level of independence...
August 5, 2017: Thorax
https://www.readbyqxmd.com/read/28770543/feasibility-and-safety-of-virtual-reality-based-early-neurocognitive-stimulation-in-critically-ill-patients
#10
Marc Turon, Sol Fernandez-Gonzalo, Mercè Jodar, Gemma Gomà, Jaume Montanya, David Hernando, Raquel Bailón, Candelaria de Haro, Victor Gomez-Simon, Josefina Lopez-Aguilar, Rudys Magrans, Melcior Martinez-Perez, Joan Carles Oliva, Lluís Blanch
BACKGROUND: Growing evidence suggests that critical illness often results in significant long-term neurocognitive impairments in one-third of survivors. Although these neurocognitive impairments are long-lasting and devastating for survivors, rehabilitation rarely occurs during or after critical illness. Our aim is to describe an early neurocognitive stimulation intervention based on virtual reality for patients who are critically ill and to present the results of a proof-of-concept study testing the feasibility, safety, and suitability of this intervention...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28730889/purposefulness-as-a-critical-factor-in-functioning-disability-and-health
#11
Joshua Y Lee, Emily A Ready, Eric N Davis, Philip C Doyle
Guided by theoretical frameworks of health and illness such as the International Classification of Functioning, Disability, and Health (ICF), we seek to describe the importance of purposefulness in the context of rehabilitation. We argue that ascribing meaning to life events, particularly changes in health, and acting in a manner that is driven by purpose is a universal characteristic of human beings. The ability to contextualize purposefulness within the broader biopsychosocial model of illness may provide a greater understanding of the relationship of purpose in the process of rehabilitation...
August 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28713659/a-descriptive-report-of-early-mobilization-for-critically-ill-ventilated-patients-with-cancer
#12
Amanda Weeks, Claudine Campbell, Prabalini Rajendram, Weiji Shi, Louis Voigt
BACKGROUND: Early mobilization protocols have been successfully implemented to improve function in critically ill patients; however, no study has focused on the oncology population. OBJECTIVES: To investigate the feasibility of early mobilization and describe the rehabilitation interventions and discharge outcomes in a cohort of critically ill patients with cancer. DESIGN: Retrospective review. METHODS: A retrospective analysis of patients with cancer who participated in occupational and physical therapy while on mechanical ventilation utilizing an institutional early mobilization protocol from June 2010 - July 2011, was completed...
July 2017: Rehabilitation Oncology
https://www.readbyqxmd.com/read/28705583/prevalence-and-risk-factors-for-colonization-by-clostridium-difficile-and-extended-spectrum-%C3%AE-lactamase-producing-enterobacteriaceae-in-rehabilitation-clinics-in-germany
#13
M Arvand, C Ruscher, G Bettge-Weller, M Goltz, Y Pfeifer
BACKGROUND: Rehabilitation clinics may vary widely in terms of type of care provided, duration of hospital stay, and case severity. Few data are available on prevalence of Clostridium difficile or extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) colonization in rehabilitation clinics in Germany. AIM: This study investigated the frequency of intestinal colonization by these pathogens among patients in rehabilitation clinics of different specialization...
July 10, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28689854/impact-of-cardiac-rehabilitation-and-exercise-training-programs-in-coronary-heart-disease
#14
REVIEW
Sergey Kachur, Vasutakarn Chongthammakun, Carl J Lavie, Alban De Schutter, Ross Arena, Richard V Milani, Barry A Franklin
Cardiovascular rehabilitation (CR) is the process of developing and maintaining an optimal level of physical, social, and psychological well-being in order to promote recovery from cardiovascular (CV) illness. It is a multi-disciplinary approach encompassing supervised exercise training, patient counseling, education and nutritional guidance that may also enhance quality of life. Beneficial CV effects may include improving coronary heart disease risk factors; particularly exercise capacity, reversing cardiac remodeling, and favorably modifying metabolism and systemic oxygen transport...
June 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28675113/low-levels-of-physical-activity-during-critical-illness-and-weaning-the-evidence-reality-gap
#15
Bronwen A Connolly, Jessica L Mortimore, Abdel Douiri, Joleen W Rose, Nicholas Hart, Susan C Berney
BACKGROUND: Physical rehabilitation can benefit critically ill patients during intensive care unit (ICU) admission, but routine clinical practice remains inconsistent nor examined in prolonged mechanical ventilation patients transferred to a specialist ventilator weaning unit (VWU). Behavioral mapping is a sampling approach that allows detailed reporting of physical activity profiles. The objective of this study was to characterize the physical activity profile of critically ill patients in a UK ICU and VWU...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28661414/muscle-mass-and-physical-recovery-in-icu-innovations-for-targeting-of-nutrition-and-exercise
#16
Paul E Wischmeyer, Zudin Puthucheary, Iñigo San Millán, Daniel Butz, Michael P W Grocott
PURPOSE OF REVIEW: We have significantly improved hospital mortality from sepsis and critical illness in last 10 years; however, over this same period we have tripled the number of 'ICU survivors' going to rehabilitation. Furthermore, as up to half the deaths in the first year following ICU admission occur post-ICU discharge, it is unclear how many of these patients ever returned home or a meaningful quality of life. For those who do survive, recent data reveals many 'ICU survivors' will suffer significant functional impairment or post-ICU syndrome (PICS)...
August 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28655615/lncrna-map2k4-sequesters-mir-199a-to-promote-fgf1-expression-and-spinal-cord-neuron-growth
#17
Hao-Ran Lv
Spinal cord injury (SCI) is a common critical illness in clinical practice. SCI prevention, treatment and rehabilitation have become important topics in today's medical profession. Studies have shown that long noncoding RNAs (lncRNAs) also play an important role in the pathology of SCI. The biology software analysis identified miR-199a binding sites in the lncRNA-Map2k4 and FGF1 sequences, which were confirmed by the subsequent dual luciferase reporter assay. When lncRNA-Map2k4 expression was down-regulated by siRNA, miR-199a expression in neurons was up-regulated and FGF1 expression was down-regulated...
August 26, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28650903/thigh-ultrasound-monitoring-identifies-decreases-in-quadriceps-femoris-thickness-as-a-frequent-observation-in-critically-ill-children
#18
Frederic V Valla, David K Young, Muriel Rabilloud, Uvaraj Periasami, Manoj John, Florent Baudin, Carole Vuillerot, Aurélie Portefaix, Deborah White, Jenna A Ridout, Rosan Meyer, Bénédicte Gaillard Le Roux, Etienne Javouhey, Nazima Pathan
OBJECTIVES: Significant muscle wasting develops in critically ill adults, with subsequent worse outcomes. In the pediatric setting, occurrence and effects of muscle wasting are undescribed; this is in part due to a lack of validated, objective methods for assessing muscle wasting. A single measurement of quadriceps femoris thickness has failed to show consistent reproducibility. We hypothesized that averaging repeated measurements could afford good reproducibility to allow for quadriceps femoris thickness decline detection and monitoring...
August 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28608135/can-proportional-ventilation-modes-facilitate-exercise-in-critically-ill-patients-a-physiological-cross-over-study-pressure-support-versus-proportional-ventilation-during-lower-limb-exercise-in-ventilated-critically-ill-patients
#19
Evangelia Akoumianaki, Nicolas Dousse, Aissam Lyazidi, Jean-Claude Lefebvre, Severine Graf, Ricardo Luiz Cordioli, Nathalie Rey, Jean-Christophe Marie Richard, Laurent Brochard
BACKGROUND: Early exercise of critically ill patients may have beneficial effects on muscle strength, mass and systemic inflammation. During pressure support ventilation (PSV), a mismatch between demand and assist could increase work of breathing and limit exercise. A better exercise tolerance is possible with a proportional mode of ventilation (Proportional Assist Ventilation, PAV+ and Neurally Adjusted Ventilatory Assist, NAVA). We examined whether, in critically ill patients, PSV and proportional ventilation have different effects on respiratory muscles unloading and work efficiency during exercise...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28600450/establishing-a-legal-service-for-major-trauma-patients-at-a-major-trauma-centre-in-the-uk
#20
William H Seligman, Julian Thompson, Hannah E Thould, Charlotte Tan, Andrew Dinsmore, David J Lockey
BACKGROUND: Major trauma causes unanticipated critical illness and patients have often made few arrangements for what are sudden and life-changing circumstances. This can lead to financial, housing, insurance, legal and employment issues for patients and their families.A UK law firm worked with the major trauma services to develop a free and comprehensive legal service for major trauma patients and their families at a major trauma centre (MTC) in the UK. METHODS: In 2013, a legal service was established at North Bristol NHS Trust...
June 9, 2017: Emergency Medicine Journal: EMJ
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