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Physiotherapy in ICU

Marianne Devroey, Catherine Buyse, Michelle Norrenberg, Anne-Marie Ros, Jean-Louis Vincent
Purpose: To document and describe the use of a hospital-wide, 24-hour cardiorespiratory physiotherapy service run by an intensive care unit (ICU) team of physiotherapists. Methods: We prospectively collected data on all non-ICU hospital patients who used the 24-hours-per-day cardiorespiratory physiotherapy service over a 1-year period between July 2013 and June 2014. The ICU physiotherapists documented the reason, origin of referral, time of call, and type and frequency of treatment of each patient. Results: Over the 1-year period, the ICU physiotherapists administered 2,192 out-of-hours cardiorespiratory physiotherapy treatments (n=685 patients) outside the ICU...
2016: Physiotherapy Canada. Physiothérapie Canada
Laveena Munshi, Tadahiro Kobayashi, Julian DeBacker, Ravi Doobay, Teagan Telesnicki, Vincent Lo, Nathalie Cote, Marcelo Cypel, Shaf Keshavjee, Niall D Ferguson, Eddy Fan
RATIONALE: There are limited data on physiotherapy during extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS). OBJECTIVES: We sought to characterize physiotherapy delivered to ARDS patients supported with ECMO, and to evaluate the association of this therapeutic modality with mortality. METHODS: We conducted a retrospective cohort study of all adult ARDS patients supported with ECMO at our institution from 2010-2015...
November 29, 2016: Annals of the American Thoracic Society
Jan Mehrholz, Simone Thomas, Jane H Burridge, André Schmidt, Bettina Scheffler, Ralph Schellin, Stefan Rückriem, Daniel Meißner, Katja Mehrholz, Wolfgang Sauter, Ulf Bodechtel, Bernhard Elsner
BACKGROUND: Critical illness myopathy (CIM) and polyneuropathy (CIP) are a common complication of critical illness. Both cause intensive-care-unit-acquired (ICU-acquired) muscle weakness (ICUAW) which increases morbidity and delays rehabilitation and recovery of activities of daily living such as walking ability. Focused physical rehabilitation of people with ICUAW is, therefore, of great importance at both an individual and a societal level. A recent systematic Cochrane review found no randomised controlled trials (RCT), and thus no supporting evidence, for physical rehabilitation interventions for people with defined CIP and CIM to improve activities of daily living...
November 24, 2016: Trials
A Fehrenbach, T Werner, A Demirci, P K Zahn, C Grüneberg
OBJECTIVE: Respiratory physiotherapy is an integral part of the care of patients in intensive care units (ICU) after cardiac surgery. One of the most commonly used techniques in ICU to prevent pulmonary complications are mechanical vibrations, which can be applied with a tool called Vibrax.The aim of this study was to investigate the effects of Vibrax (mechanical vibrations) on the arterial blood gases of patients in ICU during the 1. or 2. day after cardiac surgery. METHODS: A randomized controlled pilot study was conducted with 23 patients...
September 2016: Pneumologie
Giuseppe Frazzitta, Ilaria Zivi, Roberto Valsecchi, Sara Bonini, Sara Maffia, Katia Molatore, Luca Sebastianelli, Alessio Zarucchi, Diana Matteri, Giuseppe Ercoli, Roberto Maestri, Leopold Saltuari
BACKGROUND AND OBJECTIVE: Verticalization was reported to improve the level of arousal and awareness in patients with severe acquired brain injury (ABI) and to be safe in ICU. We evaluated the effectiveness of a very early stepping verticalization protocol on their functional and neurological outcome. METHODS: Consecutive patients with Vegetative State or Minimally Conscious State were enrolled in ICU on the third day after an ABI. They were randomized to undergo conventional physiotherapy alone or associated to fifteen 30-minute sessions of verticalization, using a tilt table with robotic stepping device...
2016: PloS One
Ufuk Kuyrukluyildiz, Orhan Binici, İlke Kupeli, Nurel Erturk, Barış Gulhan, Fethi Akyol, Adalet Ozcicek, Didem Onk, Guldane Karabakan
Objective. Effects of high frequency chest wall oscillation technique were investigated on intubated ICU patients. Background. Thirty intubated patients were included in the study. The control group (n = 15) received routine pulmonary rehabilitation technique. In addition to the pulmonary rehabilitation technique, the study group (n = 15) was given high frequency chest wall oscillation (HFCWO). APACHE II, dry sputum weight, lung collapse index, and blood gas values were measured at 24th, 48th, and 72nd hours and endotracheal aspirate culture was studied at initial and 72nd hour...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
M Osseis, J Weyrech, E Gayat, S Dagois, R Lo Dico, M Pocard, C Eveno
BACKGROUND: Although Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) confers health benefits in peritoneal carcinomatosis (PC) treatment, it is associated with significant postoperative morbidity and mortality rate with increased length of hospital stay. The goal of this study is to determine whether a new comprehensive physiotherapy program including epidural loco-regional analgesia can improve the quality of care and patients recovery. METHODS: Between 2009 and 2013, 124 patients with PC were operated for CRS and HIPEC procedures...
June 27, 2016: European Journal of Surgical Oncology
Konrad Schmidt, Susanne Worrack, Michael Von Korff, Dimitry Davydow, Frank Brunkhorst, Ulrike Ehlert, Christine Pausch, Juliane Mehlhorn, Nico Schneider, André Scherag, Antje Freytag, Konrad Reinhart, Michel Wensing, Jochen Gensichen
IMPORTANCE: Survivors of sepsis face long-term sequelae that diminish health-related quality of life and result in increased care needs in the primary care setting, such as medication, physiotherapy, or mental health care. OBJECTIVE: To examine if a primary care-based intervention improves mental health-related quality of life. DESIGN, SETTING, AND PARTICIPANTS: Randomized clinical trial conducted between February 2011 and December 2014, enrolling 291 patients 18 years or older who survived sepsis (including septic shock), recruited from 9 intensive care units (ICUs) across Germany...
June 28, 2016: JAMA: the Journal of the American Medical Association
Margot Green, Vince Marzano, I Anne Leditschke, Imogen Mitchell, Bernie Bissett
OBJECTIVES: To describe our experience and the practical tools we have developed to facilitate early mobilization in the intensive care unit (ICU) as a multidisciplinary team. BACKGROUND: Despite the evidence supporting early mobilization for improving outcomes for ICU patients, recent international point-prevalence studies reveal that few patients are mobilized in the ICU. Existing guidelines rarely address the practical issues faced by multidisciplinary ICU teams attempting to translate evidence into practice...
2016: Journal of Multidisciplinary Healthcare
Christopher L Carroll, Edward Vincent S Faustino, Matthew G Pinto, Kathleen A Sala, Michael F Canarie, Simon Li, John S Giuliano, The Northeast Pediatric Critical Care Research Consortium
OBJECTIVE: To describe the treatment practices in critically ill children with RSV bronchiolitis across four regional PICUs in the northeastern United States, and to determine the factors associated with increased ICU length of stay in this population. METHODS: We conducted a retrospective cohort study of children who were admitted with RSV bronchiolitis between July 2009 and July 2011 to the PICUs of Connecticut Children's Medical Center, Yale-New Haven Children's Hospital, Maria Fareri Children's Hospital, and Baystate Children's Hospital...
December 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Marc Nickels, Leanne M Aitken, James Walsham, Lisa Watson, Steven McPhail
BACKGROUND: Rehabilitative exercise for critically ill patients may have many benefits; however, it is unknown what intensive care unit (ICU) clinicians perceive to be important rationale for the implementation of rehabilitative exercise in critical care settings. OBJECTIVE: To identify which rationales for rehabilitative exercise interventions were perceived by ICU clinicians to be important and determine whether perceptions were consistent across nursing, medical and physiotherapy clinicians...
April 19, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Sumana Baidya, Ranjeeta S Acharya, Michel W Coppieters
CONTEXT: As physiotherapy (PT) is a young profession in Nepal, there is a dearth of insight into the common practices of physiotherapists in critical care. AIMS: To identify the availability of PT services in Intensive Care Units (ICUs) and articulate the common practices by physiotherapists in ICUs of Nepal. SETTINGS AND DESIGN: All tertiary care hospitals across Nepal with ICU facility via an exploratory cross-sectional survey. SUBJECTS AND METHODS: An existing questionnaire was distributed to all the physiotherapists currently working in ICUs of Nepal with 2 years of experience...
February 2016: Indian Journal of Critical Care Medicine
Michelle E Kho, Alexander J Molloy, France Clarke, Margaret S Herridge, Karen K Y Koo, Jill Rudkowski, Andrew J E Seely, Joseph R Pellizzari, Jean-Eric Tarride, Marina Mourtzakis, Timothy Karachi, Deborah J Cook
INTRODUCTION: Early exercise with in-bed cycling as part of an intensive care unit (ICU) rehabilitation programme has the potential to improve physical and functional outcomes following critical illness. The objective of this study is to determine the feasibility of enrolling adults in a multicentre pilot randomised clinical trial (RCT) of early in-bed cycling versus routine physiotherapy to inform a larger RCT. METHODS AND ANALYSIS: 60-patient parallel group pilot RCT in 7 Canadian medical-surgical ICUs...
April 8, 2016: BMJ Open
Shilpi Misra
Pulmonary complications, especially postoperative pulmonary complications, are an important cause of morbidity and mortality in neurosurgical patients. Hypoxemia due to mucus plug causing lung collapse is a rare event. We report a case of a 40-year-old female with right cerebellopontine angle space occupying lesion, scheduled for elective craniotomy and tumor excision. The patient underwent surgery uneventfully and was shifted to Intensive Care Unit (ICU) for monitoring. Eight hours after extubation, she developed hypoxemia due to mucus plug resulting in left lung collapse...
January 2016: Anesthesia, Essays and Researches
Hélène Laurent, Sylvie Aubreton, Ruddy Richard, Yannael Gorce, Emilie Caron, Aurélie Vallat, Anne-Marie Davin, Jean-Michel Constantin, Emmanuel Coudeyre
INTRODUCTION: Practice guidelines recommend early physical therapy in intensive care units (ICU). Feasibility, safety and efficacy are confirmed by growing evidence-based data. PURPOSE: To perform a qualitative systematic literature review on early exercise in ICUs, focused on the subject areas of "how to do", "for which patients" and "for what benefits". METHODS: Articles were obtained from the PubMed, Google Scholar, Physiotherapy Evidence Database (PEDro), Embase, CINAHL, CENTRAL, Cochrane and ReeDOC databases...
April 2016: Anaesthesia, Critical Care & Pain Medicine
Bernie Bissett, Margot Green, Vince Marzano, Susannah Byrne, I Anne Leditschke, Teresa Neeman, Robert Boots, Jennifer Paratz
OBJECTIVES: To establish the inter-rater reliability of the Acute Care Index of Function (ACIF) in intensive care unit (ICU) patients and determine whether ACIF scores have predictive utility beyond ICU discharge. BACKGROUND: Accurate and reliable measures of physical function are required to describe the recovery trajectory of ICU survivors. The clinimetric properties of the ACIF are yet to be established in ICU patients. METHODS: Prospective observational study in a single tertiary ICU...
January 2016: Heart & Lung: the Journal of Critical Care
D Marienfeld
BACKGROUND: Obese patients in the intensive care unit (ICU) represent an interesting topic, which is currently receiving increased attention from physiotherapists. OBJECTIVE: The aim of this article is to present the options and limitations of physiotherapy which must be overcome in the daily routine in the ICU. RESULTS: The quality of therapeutic treatment of obese inpatients has shown a clear increase during the last 20 years; however, sufficient studies have not yet been carried out, international standards are not available and many therapists work differently with their patients...
March 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Cathrine Tadyanemhandu, Shamila Manie
BACKGROUND: Physiotherapy is integral to patient management in the Intensive Care Unit. The precise role that physiotherapists play in the critical care differs significantly worldwide. The aim of the study was to describe the profile of patients and the current patterns of physiotherapy services delivered for patients admitted in the five public hospital intensive care units in Zimbabwe. METHODS: A prospective record review was performed and records of all consecutive patients admitted into the five units during a two months period were included in the analysis...
2015: BMC Anesthesiology
Debora A S Faria, Edina M K da Silva, Álvaro N Atallah, Flávia M R Vital
BACKGROUND: Each year, more than four million abdominal surgeries are performed in the US and over 250,000 in England. Acute respiratory failure, a common complication that can affect 30% to 50% of people after upper abdominal surgery, can lead to significant morbidity and mortality. Noninvasive ventilation has been associated with lower rates of tracheal intubation in adults with acute respiratory failure, thus reducing the incidence of complications and mortality. This review compared the effectiveness and safety of noninvasive positive pressure ventilation (NPPV) versus standard oxygen therapy in the treatment of acute respiratory failure after upper abdominal surgery...
2015: Cochrane Database of Systematic Reviews
Masoumeh Bagheri-Nesami, Maryam Amiri-Abchuyeh, Afshin Gholipour-Baradari, Jamshid Yazdani-Cherati, Attieh Nikkhah
BACKGROUND: The implementation of guidelines for the prevention of Ventilator-associated pneumonia has been shown to have a significant effect in reducing the incidence of VAP. OBJECTIVE: The aim of the present study was to evaluate the implementation of the preventive strategies for VAP in ICUs of university hospitals of Sari, Iran. MATERIALS AND METHODS: This cross-sectional study was carried out in 600 beds/day in the ICUs of university hospitals of Sari from April to June 2012...
August 2015: Journal of Clinical and Diagnostic Research: JCDR
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