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early mobility icu

Leanne M Boehm, Eduard E Vasilevskis, Lorraine C Mion
BACKGROUND: The ABCDE bundle is a multifaceted, interprofessional intervention that is associated with reduced ventilator and delirium days as well as increased likelihood of mobility in intensive care. OBJECTIVES: The aim of this study is to describe organizational domains that contribute to variation in ABCDE bundle implementation as reported by intensive care unit providers and to examine the capability of a conceptual framework for identifying variation in ABCDE bundle implementation...
November 2016: Dimensions of Critical Care Nursing: DCCN
Floriana Pinto, Gianni Biancofiore
BACKGROUND: The ABCDE (Awakening and Breathing coordination of daily sedation and ventilator removal trials; Choice of sedative or analgesic exposure; Delirium monitoring and management; and Early mobility and exercise) bundle is a multidisciplinary set of evidence-based practices for improving patient outcomes in the intensive care unit. Nurses are critical to all the bundle's requirements. Therefore, understanding their knowledge, attitudes, and perception of the different bundle's components might help for an easier implementation into everyday clinical practice...
November 2016: Dimensions of Critical Care Nursing: DCCN
David McWilliams, Gemma Atkins, James Hodson, Catherine Snelson
BACKGROUND: Early mobility within the ICU is associated with a number of positive outcomes including reductions in ICU and hospital length of stay and better functional recovery. The exact definition of 'early' mobility is still not defined, with the actual ability to mobilise limited by a number of perceived factors. The Sara Combilizer is a combined tilt table and stretcher chair, which allows passive transfer of patients out of bed. This study aimed to assess whether the introduction of the Sara Combilizer reduced time taken to first mobilise for patients mechanically ventilated for at least five days and at risk of ICU acquired weakness...
October 10, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Karen K Y Koo, Karen Choong, Deborah J Cook, Margaret Herridge, Anastasia Newman, Vincent Lo, Gordon Guyatt, Fran Priestap, Eileen Campbell, Karen E A Burns, FranÇois Lamontagne, Maureen O Meade
BACKGROUND: The promotion of early mobilization following critical illness is tempered by national reports of patient and institutional barriers to this approach. We carried out a survey to assess current knowledge, perceptions and practices of Canadian physicians and physiotherapists with respect to acquired weakness and early mobilization in adults in the intensive care unit (ICU). METHODS: We conducted a cross-sectional, self-administered postal survey among critical care physicians and physiotherapists in all 46 academic ICUs in Canada in 2011-2012...
July 2016: CMAJ Open
Stefan J Schaller, Matthew Anstey, Manfred Blobner, Thomas Edrich, Stephanie D Grabitz, Ilse Gradwohl-Matis, Markus Heim, Timothy Houle, Tobias Kurth, Nicola Latronico, Jarone Lee, Matthew J Meyer, Thomas Peponis, Daniel Talmor, George C Velmahos, Karen Waak, J Matthias Walz, Ross Zafonte, Matthias Eikermann
BACKGROUND: Immobilisation predicts adverse outcomes in patients in the surgical intensive care unit (SICU). Attempts to mobilise critically ill patients early after surgery are frequently restricted, but we tested whether early mobilisation leads to improved mobility, decreased SICU length of stay, and increased functional independence of patients at hospital discharge. METHODS: We did a multicentre, international, parallel-group, assessor-blinded, randomised controlled trial in SICUs of five university hospitals in Austria (n=1), Germany (n=1), and the USA (n=3)...
October 1, 2016: Lancet
Sarah Elizabeth Jolley, Marc Moss, Dale M Needham, Ellen Caldwell, Peter E Morris, Russell R Miller, Nancy Ringwood, Megan Anders, Karen K Koo, Stephanie E Gundel, Selina M Parry, Catherine L Hough
OBJECTIVE: Early mobility in mechanically ventilated patients is safe, feasible, and may improve functional outcomes. We sought to determine the prevalence and character of mobility for ICU patients with acute respiratory failure in U.S. ICUs. DESIGN: Two-day cross-sectional point prevalence study. SETTING: Forty-two ICUs across 17 Acute Respiratory Distress Syndrome Network hospitals. PATIENTS: Adult patients (≥ 18 yr old) with acute respiratory failure requiring mechanical ventilation...
September 22, 2016: Critical Care Medicine
Claudia C Dos Santos, Margaret Herridge, Jane Batt
No abstract text is available yet for this article.
August 2016: Journal of Thoracic Disease
P Nydahl, R Dubb, S Filipovic, C Hermes, F Jüttner, A Kaltwasser, S Klarmann, H Mende, S Nessizius, C Rottensteiner
Immobility of patients in intensive care units (ICU) can lead to long-lasting physical and cognitive decline. During the last few years, bundles for rehabilitation were developed, including early mobilization. The German guideline for positioning therapy and mobilization, in general, recommends the development of ICU-specific protocols. The aim of this narrative review is to provide guidance when developing a best practice protocol in one's own field of work. It is recommended to a) implement early mobilization as part of a bundle, including screening and management of patient's awareness, pain, anxiety, stress, delirium and family's presence, b) develop a traffic-light system of specific in- and exclusion criteria in an interprofessional process, c) use checklists to assess risks and preparation of mobilization, d) use the ICU Mobility Scale for targeting and documentation of mobilization, e) use relative safety criteria for hemodynamic and respiratory changes, and Borg Scale for subjective evaluation, f) document and evaluate systematically mobilization levels, barriers, unwanted safety events and other parameters...
September 6, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Marie Oxenbøll-Collet, Ingrid Egerod, Vibeke Christensen, Jeannette Jensen, Thordis Thomsen
BACKGROUND: Delirium in the intensive care unit (ICU) has received more attention in the past decade. Early detection, prevention and treatment of delirium are important, and the most commonly used tool for delirium assessment is the Confusion Assessment Method for the ICU (CAM-ICU). AIM: The aim of this study was to identify nurses' and physicians' perceived professional barriers to using the CAM-ICU in Danish ICUs. METHODS: This study uses a qualitative explorative multicentre design using focus groups and a semi-structured interview guide...
September 5, 2016: Nursing in Critical Care
Huan Deng, Jian Chen, Frank Li, Cecilia W P Li-Tsang, Qiushi Liu, Xiaohong Ma, Ming Ao, Nan Chen, Yaqin Zhou, Xiaoyun Zhong, Zhiyu Chen, Lei Cao, Guiyang He, Jun Wu
PURPOSE: To assess the effects of mobility training on severe burn patients in the Burn Intensive Care Unit (BICU). METHODS: This was a retrospective cohort study. Severe burn patients with equal to or more than 50% Total Body Surface Area (TBSA) burns who received early rehabilitation in the BICU were included in this study. Based on the different early rehabilitation strategies during the two periods, patients admitted to the BICU from January 2011 to April 2013 were identified as the passive training cohort (n=49) while patients admitted to the BICU from May 2013 to December 2013 were identified as the mobility training cohort (n=24)...
November 2016: Burns: Journal of the International Society for Burn Injuries
Linda Denehy, Julie Lanphere, Dale M Needham
No abstract text is available yet for this article.
August 25, 2016: Intensive Care Medicine
Ajith John George, Shalini Nair, Jayanthi Chinnaiya Karthic, Mathew Joseph
INTRODUCTION: Deep venous thrombosis (DVT) is thought to be less common in Asians than in Caucasian population. The incidence of DVT in high-risk groups, especially the neurosurgical (NS) patients, has not been well studied. This leaves no firm basis for the start of early prophylactic anticoagulation within first 5 postoperative days in Indian NS patients. This is a prospective observational study to determine the early occurrence of DVT in the NS patients. PATIENTS AND METHODS: We screened 137 consecutive high-risk NS patients based on inclusion and exclusion criteria...
July 2016: Indian Journal of Critical Care Medicine
Cheryl Elizabeth Hickmann, Diego Castanares-Zapatero, Emilie Bialais, Jonathan Dugernier, Antoine Tordeur, Lise Colmant, Xavier Wittebole, Giuseppe Tirone, Jean Roeseler, Pierre-François Laterre
BACKGROUND: Early mobilization in critically ill patients has been shown to prevent bed-rest-associated morbidity. Reported reasons for not mobilizing patients, thereby excluding or delaying such intervention, are diverse and comprise safety considerations for high-risk critically ill patients with multiple organ support systems. This study sought to demonstrate that early mobilization performed within the first 24 h of ICU admission proves to be feasible and well tolerated in the vast majority of critically ill patients...
December 2016: Annals of Intensive Care
Deena Kelly Costa, Jennifer Dammeyer, Matthew White, Jose Galinato, Robert Hyzy, Milisa Manojlovich, Anne Sales
BACKGROUND: The awakening and breathing coordination, delirium, and early mobility (ABCDE) bundle is a multicomponent complex intervention that improves outcomes for critically ill adults yet is inconsistently implemented. Effective interprofessional team function (how the team interacts) is key to ABCDE delivery but little is known about how to measure team interactions. The purpose of our study was to examine the reliability of an observational rating tool to assess team interactions about ABCDE in one ICU...
2016: BMC Research Notes
Andrew Abboud, Rami A Namas, Mostafa Ramadan, Qi Mi, Khalid Almahmoud, Othman Abdul-Malak, Nabil Azhar, Akram Zaaqoq, Rajaie Namas, Derek A Barclay, Jinling Yin, Jason Sperry, Andrew Peitzman, Ruben Zamora, Richard L Simmons, Timothy R Billiar, Yoram Vodovotz
OBJECTIVE: Blunt trauma patients may present with similar demographics and injury severity yet differ with regard to survival. We hypothesized that this divergence was due to different trajectories of systemic inflammation and utilized computational analyses to define these differences. DESIGN: Retrospective clinical study and experimental study in mice. SETTING: Level 1 trauma center and experimental laboratory. PATIENTS: From a cohort of 493 victims of blunt trauma, we conducted a pairwise, retrospective, case-control study of patients who survived over 24 hours but ultimately died (nonsurvivors; n = 19) and patients who, after ICU admission, went on to be discharged(survivors; n = 19)...
November 2016: Critical Care Medicine
C Hermes, P Nydahl, D Henzler, T Bein
The 2007 guidelines "Positioning for prophylaxis and therapy of pulmonary disorders" were completely revised in 2015 on behalf of the German Society of Anaesthesiology and Intensive Care Medicine. With regard to practical and scientific relevance, early mobilization of patients in critical care has been included in the guidelines for the first time. Furthermore, the recommendations for prone positioning have been updated, based on current evidence in medicine and nursing. In addition, recommendations regarding unsuitable positions that may actually harm patients were made...
September 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Shunsuke Taito, Nobuaki Shime, Kohei Ota, Hideto Yasuda
Several recent studies have suggested that the early mobilization of mechanically ventilated patients in the intensive care unit is safe and effective. However, in these studies, few patients reached high levels of active mobilization, and the standard of care among the studies has been inconsistent. The incidence of adverse events during early mobilization is low. Its importance should be considered in the context of the ABCDE bundle. Protocols of early mobilization with strict inclusion and exclusion criteria are needed to further investigate its contributions...
2016: Journal of Intensive Care
Tatsuhiro Fujii, Gabriela Moriel, Daniel R Kramer, Frank Attenello, Gabriel Zada
Over the past several decades, the rate of traumatic brain injury (TBI)-related emergency room visits in the United States has steadily increased, yet mortality in these patients has decreased. This improvement in outcome is largely due to advances in prehospital care, intensive care unit management, and the effectiveness of neurosurgical procedures, such as decompressive craniectomies. It is imperative to identify clinical factors predictive of patients who benefit from early mobilization of resources and operative treatment...
September 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Tiziano Cassina, Alessandro Putzu, Luisa Santambrogio, Michele Villa, Marc Joseph Licker
BACKGROUND: Active mobilization is a key component in fast-track surgical strategies. Following major surgery, clinicians are often reluctant to mobilize patients arguing that circulatory homeostasis would be impaired as a result of myocardial stunning, fluid shift, and autonomic dysfunction. AIMS: We examined the feasibility and safety of a mobilization protocol 12-24 h after elective cardiac surgery. SETTING AND DESIGN: This observational study was performed in a tertiary nonacademic cardiovascular Intensive Care Unit...
July 2016: Annals of Cardiac Anaesthesia
Anup Bhat, Kalyana Chakravarthy, Bhamini K Rao
CONTEXT: The rehabilitation needs of the patients in neurological Intensive Care Units (ICUs) vary from that of a medical ICU patient. Early mobilization is known to improve the various neurological outcomes in patients admitted to neurological ICUs, although little is known about the practice pattern among physiotherapists. The mobilization practice pattern may vary significantly than that of developed countries due to the reasons of differences in training of professionals, availability of equipment, and financial assistance by health insurance...
June 2016: Indian Journal of Critical Care Medicine
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