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https://www.readbyqxmd.com/read/29351145/recent-evidence-on-early-mobilization-in-critical-ill-patients
#1
Kristina Fuest, Stefan J Schaller
PURPOSE OF REVIEW: To examine the benefits of early mobilization and summarize the results of most recent clinical studies examining early mobilization in critically ill patients followed by a presentation of recent developments in the field. RECENT FINDINGS: Early mobilization of ICU patients, defined as mobilization within 72 h of ICU admission, is still uncommon. In medical and surgical critically ill patients, mobilization is well tolerated even in intubated patients...
January 17, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29349777/in-bed-cycling-in-the-icu-patient-safety-and-recollections-with-motivational-effects
#2
M Ringdal, M Warren Stomberg, K Egnell, E Wennberg, R Zätterman, C Rylander
BACKGROUND: In-bed cycling (IBC) is gaining interest for implementation in intensive care units. Our main objective was to explore patient recollections and experiences of early mobilization, including IBC. Secondly, we aimed to examine if IBC was safe and feasible. METHODS: Eleven participants were interviewed about their experiences during their critical illnesses and active mobilization in the intensive care unit. The interviews were analyzed thematically. Six participants were also monitored for physiological reactions and adverse events during IBC while mechanically ventilated...
January 18, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29340541/safety-criteria-to-start-early-mobilization-in-intensive-care-units-systematic-review
#3
Thais Martins Albanaz da Conceição, Ana Inês Gonzáles, Fernanda Cabral Xavier Sarmento de Figueiredo, Danielle Soares Rocha Vieira, Daiana Cristine Bündchen
Mobilization of critically ill patients admitted to intensive care units should be performed based on safety criteria. The aim of the present review was to establish which safety criteria are most often used to start early mobilization for patients under mechanical ventilation admitted to intensive care units. Articles were searched in the PubMed, PEDro, LILACS, Cochrane and CINAHL databases; randomized and quasi-randomized clinical trials, cohort studies, comparative studies with or without simultaneous controls, case series with 10 or more consecutive cases and descriptive studies were included...
October 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29331668/earlier-and-enhanced-rehabilitation-of-mechanically-ventilated-patients-in-critical-care-a-feasibility-randomised-controlled-trial
#4
David McWilliams, Charlotte Jones, Gemma Atkins, James Hodson, Tony Whitehouse, Tonny Veenith, Emma Reeves, Lauren Cooper, Catherine Snelson
BACKGROUND: Systematic reviews of early rehabilitation within intensive care units have highlighted the need for robust multi-centre randomised controlled trials with longer term follow up. This trial aims to explore the feasibility of earlier and enhanced rehabilitation for patients mechanically ventilated for ≥5days and to assess the impact on possible long term outcome measures for use in a definitive trial. METHODS: Patients admitted to a large UK based intensive care unit and invasively ventilated for ≥5days were randomised to the rehabilitation intervention or standard care on a 1:1 basis, stratified by age and SOFA score...
January 4, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29276219/indirect-calorimetry-measurement-of-energy-expenditure-related-to-body-position-changes-in-healthy-adults
#5
Kengo Obata, Tetsuya Yumoto, Soichiro Fuke, Kohei Tsukahara, Hiromichi Naito, Atsuyoshi Iida, Tetsuya Takahashi, Yoshihito Ujike, Atsunori Nakao
Early mobilization is advocated to prevent intensive care unit-acquired physical weakness, but the patient's workload and its changes in response to body position changes have not been established. We used indirect calorimetry to determine the energy expenditure (EE) in response to body position changes, and we assessed EE's correlation with respiratory parameters in healthy volunteers: 8 males and 8 females, mean age 23.4±1.3 years. The subjects started in the resting supine position followed by a 30° head-up position, a 60° head-up position, an upright sitting position, a standing position, and the resting supine position...
December 2017: Acta Medica Okayama
https://www.readbyqxmd.com/read/29276146/prognostic-impact-of-prolonged-cross-clamp-time-in-coronary-artery-bypass-grafting
#6
Vito G Ruggieri, Karl Bounader, Jean Philippe Verhoye, Francesco Onorati, Antonino S Rubino, Giuseppe Gatti, Tuomas Tauriainen, Marisa De Feo, Daniel Reichart, Magnus Dalén, Peter Svenarud, Giuseppe Faggian, Giuseppe Santarpino, Daniele Maselli, Riccardo Gherli, Giovanni Mariscalco, Antonio Salsano, Francesco Nicolini, Tiziano Gherli, Matteo Saccocci, Juhani K E Airaksinen, Sidney Chocron, Andrea Perrotti, Fausto Biancari
BACKGROUND: The prognostic impact of cross-clamp time (XCT) in patients undergoing isolated coronary artery bypass grafting (CABG) has not been thoroughly investigated. MATERIAL AND METHODS: 2957 patients who underwent on-pump isolated CABG from the prospective multicentre E-CABG study were the subjects of this analysis. RESULTS: The mean XCT in this series was 58±25minutes Cross-clamp time was >60 minutes in 1134 patients (38.3%), >75minutes in 619 patients (20...
October 6, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29260012/time-courses-of-plasma-il-6-and-hmgb-1-reflect-initial-severity-of-clinical-presentation-but-do-not-predict-poor-neurologic-outcome-following-subarachnoid-hemorrhage
#7
Heikki Kiiski, Jaakko Långsjö, Jyrki Tenhunen, Marika Ala-Peijari, Heini Huhtala, Mari Hämäläinen, Eeva Moilanen, Juha Öhman, Jukka Peltola
Objective: Patients with aneurysmal subarachnoid hemorrhage (aSAH) experience high mortality and morbidity. Neuroinflammation causes brain damage expansion after aSAH. Due to the complexity of the inflammatory response multiple biomarkers are needed to evaluate its' progression. We studied inflammatory process after aSAH by measuring two inflammatory biomarkers, interleukin-6 (IL-6) and high-mobility group box 1 (HMGB1) at simultaneous time-points after aSAH. Methods: In this prospective population-based study, IL-6 and HMGB1 were measured in aSAH patients (n = 47) for up to five days...
March 2017: ENeurologicalSci
https://www.readbyqxmd.com/read/29251207/perioperative-outcomes-from-the-prospective-multicenter-least-invasive-fast-track-evar-life-registry
#8
Zvonimir Krajcer, Venkatesh G Ramaiah, Esteban A Henao, D Chris Metzger, Wayne K Nelson, Mohammed M Moursi, Hiranya A Rajasinghe, Raed Al-Dallow, Larry E Miller
PURPOSE: To determine the feasibility, perioperative resource utilization, and safety of a fast-track endovascular aneurysm repair (EVAR) protocol in well-selected patients. METHODS: Between October 2014 and May 2016, the LIFE (Least Invasive Fast-track EVAR) registry ( ClinicalTrials.gov identifier NCT02224794) enrolled 250 patients (mean age 73±8 years; 208 men) in a fast-track EVAR protocol comprised of bilateral percutaneous access using the 14-F Ovation stent-graft, no general anesthesia, no intensive care unit (ICU) admission, and next-day discharge...
December 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29242519/timing-and-amount-of-physical-therapy-treatment-are-associated-with-length-of-stay-in-the-cardiothoracic-icu
#9
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
https://www.readbyqxmd.com/read/29217105/influence-of-muscle-strength-on-early-mobility-in-critically-ill-adult-patients-systematic-literature-review
#10
REVIEW
Audrey R Roberson, Angela Starkweather, Catherine Grossman, Edmund Acevedo, Jeanne Salyer
BACKGROUND: Muscle strength may be one indicator of readiness to mobilize that can be used to guide decisions regarding early mobility efforts and to progressively advance mobilization. OBJECTIVES: To provide a synthesis of current measures of muscle strength in the assessment of early mobilization in critically ill adult patients who are receiving MV therapy. METHODS: Research studies conducted between 2000-2015 were identified using PubMed, CINHAL, MEDLINE, and the Cochrane Database of Systematic Reviews databases using the search terms "muscle strength", "intensive care", "mechanical ventilation" and "muscle weakness"...
January 2018: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/29209737/early-mobilization-of-patients-with-non-operative-liver-and-spleen-injuries-is-safe-and-cost-effective
#11
Amanda Teichman, Dane Scantling, Brendan McCracken, James Eakins
PURPOSE: There is no standard protocol for the management of non-operative liver or spleen injuries (LSI). In 2011, our institution changed the non-operative management (NOM) protocol of LSI from prolonged bed rest (PBR) to early mobilization (EM). We aim to show that EM safely decreases length of stay (LOS), ICU LOS, and cost. METHODS: We conducted a retrospective review in which non-operative LSI patients observed PBR from January 2008 through July 2011 and were mobilized early from August 2011 through December 2014...
December 5, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29196586/implementing-a-multicomponent-intervention-to-prevent-delirium-among-critically-ill-patients
#12
Felipe Martínez, Ana María Donoso, Carla Marquez, Eduardo Labarca
BACKGROUND: Delirium is common among the critically ill. Nonpharmacologic interventions are reportedly effective in reducing incident delirium, but limited data specific to this population exist. OBJECTIVES: To assess the efficacy and describe the implementation strategy of a multicomponent intervention to prevent delirium in an intensive care unit. METHODS: A before-and-after study was conducted in an intensive care unit between May 2014 through August 2015...
December 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/29186746/-interdisciplinary-acute-medical-rehabilitation-after-sepsis-a-retrospective-analysis
#13
Max Emanuel Liebl, Nancy Elmer, Christine Schwedtke, Isabelle Schröder, Anett Reißhauer
Background Surviving sepsis may have consequences of high impact for the patients' further life regarding functioning in mobility and activities of daily living, among other fields. Patients consecutively have a great need of rehabilitation interventions beginning with early mobilization in the Intensive Care Unit ICU. Acute medical rehabilitation is a concept of early rehabilitation still in the acute care hospital, normally beginning after a direct transferal from the ICU. Its aim is to improve the patients' functioning in mobility and activities of daily living (ADL) to enable further post-acute rehabilitation interventions...
November 29, 2017: Die Rehabilitation
https://www.readbyqxmd.com/read/29167075/provider-beliefs-regarding-early-mobilization-in-the-pediatric-intensive-care-unit
#14
Christine L Joyce, Cosme Taipe, Brittany Sobin, Marissa Spadaro, Batsheva Gutwirth, Larissa Elgin, Gabrielle Silver, Bruce M Greenwald, Chani Traube
PURPOSE: Critically ill patients are at risk for short and long term morbidity. Early mobilization (EM) of critically ill adults is safe and feasible, with improvement in outcomes. There are limited studies evaluating EM in pediatric critical care patients. Provider beliefs and concerns must be evaluated prior to EM implementation in the pediatric intensive care unit (PICU). DESIGN AND METHODS: A survey was distributed to PICU providers assessing beliefs and concerns with regards to EM of PICU patients...
October 14, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29132505/the-mobility-and-impact-of-frailty-in-the-intensive-care-unit
#15
REVIEW
Bellal Joseph, Faisal S Jehan
Prevalence of pre-existing frailty in patients admitted to the intensive care unit (ICU) is increasing. Critical illness leads to a catabolic state that further diminishes body reserves and contributes to frailty independent of age and prehospital functional status. Because early mobilization of patients in the ICU results in accelerated recovery and improvement in functional status and quality of life, frailty can severely affect the mobility of patients in ICU ultimately prolonging recovery. Understanding the concept of frailty and the association of frailty and its impact on mobility in the ICU, identifying patients, and timely resource allocation helps in optimum care and improves clinical outcomes...
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29096231/the-feasibility-study-of-computer-cognitive-senior-assessment-system-screen-cosas-s-in-critically-ill-patients-with-sepsis
#16
Eun-Young Kang, Sung Ju Jee, Cuk-Seong Kim, Kwang-Sun Suh, Alex W K Wong, Jae Young Moon
PURPOSE: Early cognitive assessment in the intensive care unit (ICU) is essential to monitor cognitive dysfunction after critical illness. We have implemented a Computer Cognitive Senior Assessment System-Screen (CoSAS-S) which is a brief, objective, and tablet-based cognitive screening test as a mobile platform to detect any cognitive problems in ICUs. This study aimed to evaluate the feasibility and initial validation of a tablet-based CoSAS-S in critically ill patients with sepsis...
October 10, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29089461/physical-function-in-subjects-requiring-extracorporeal-membrane-oxygenation-before-or-after-lung-transplantation
#17
Kate Hayes, Carol L Hodgson, Vincent A Pellegrino, Greg Snell, Benjamin Tarrant, Louise M Fuller, Anne E Holland
INTRODUCTION: Extracorporeal membrane oxygenation (ECMO) is used as a rescue therapy before and after lung transplantation, but little is known about functional recovery or complications after ECMO in this cohort. This study aimed to describe early physical function and leg complications in subjects who received ECMO before or after lung transplantation, and to compare functional outcomes to a matched cohort of subjects who did not require ECMO. METHODS: A retrospective study was conducted over 2 years...
October 31, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29079016/the-8-year-experience-of-the-florence-referral-ecmo-center-and-retrieval-team-for-acute-respiratory-failure
#18
Giovanni Cianchi, Chiara Lazzeri, Manuela Bonizzoli, Stefano Batacchi, Morena Cozzolino, Marco Ciapetti, Pasquale Bernardo, Andrea Franci, Marco Chiostri, Adriano Peris
OBJECTIVE: Many extracorporeal membrane oxygenation (ECMO) centers for respiratory failure and ECMO mobile teams were instituted during the H1N1 pandemic. Data on transportation are scarce and heterogeneous. The authors therefore described the experience of their referral ECMO center for severe respiratory failure from 2009 to 2016 and gave a comprehensive report of transfers performed by their mobile ECMO team. DESIGN: Observational retrospective study. SETTING: An intensive care unit (ECMO referral center) in a teaching hospital...
June 8, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29073462/implementing-early-mobilisation-in-the-intensive-care-unit-an-integrative-review
#19
REVIEW
Sonja Phelan, Frances Lin, Marion Mitchell, Wendy Chaboyer
BACKGROUND: The intensive care unit provides complex care for critically ill patients. Consequently, due to the nature of critical illness and the therapies administered in intensive care, patients are often on prolonged periods of bed rest with limited mobility. It has been recognised that mobilising critically ill patients is beneficial to patients' recovery, however implementing early mobility as a standard of care remains challenging in practice. OBJECTIVES: To identify the key factors that underpin successful implementation and sustainability of early mobilisation in adult intensive care units...
October 2, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29061618/critical-care-cycling-study-cyclist-trial-protocol-a-randomised-controlled-trial-of-usual-care-plus-additional-in-bed-cycling-sessions-versus-usual-care-in-the-critically-ill
#20
Marc R Nickels, Leanne M Aitken, James Walsham, Adrian G Barnett, Steven M McPhail
INTRODUCTION: In-bed cycling with patients with critical illness has been shown to be safe and feasible, and improves physical function outcomes at hospital discharge. The effects of early in-bed cycling on reducing the rate of skeletal muscle atrophy, and associations with physical and cognitive function are unknown. METHODS AND ANALYSIS: A single-centre randomised controlled trial in a mixed medical-surgical intensive care unit (ICU) will be conducted. Adult patients (n=68) who are expected to be mechanically ventilated for more than 48 hours and remain in ICU for a further 48 hours from recruitment will be randomly allocated into either (1) a usual care group or (2) a group that receives usual care and additional in-bed cycling sessions...
October 22, 2017: BMJ Open
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