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Physiotherapy in ICU

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https://www.readbyqxmd.com/read/28185721/approaches-and-adjuncts-used-by-physiotherapists-when-suctioning-adult-patients-who-are-intubated-and-ventilated-in-intensive-care-units-in-australia-and-new-zealand-a-cross-sectional-survey
#1
Charissa S L Tan, Meg Harrold, Kylie Hill
BACKGROUND: Suctioning is an integral component of care for patients who are intubated and ventilated in an intensive care unit (ICU). There appears to be no published data of physiotherapy suctioning practices in Australia or New Zealand. OBJECTIVE: To describe suctioning practices and the factors which have shaped these practices, of experienced physiotherapists working with adults who are intubated and ventilated in an ICU across Australia and New Zealand. Areas of investigation focused on: (i) suctioning approach (i...
February 6, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28116462/-physiotherapy-interventions-in-the-icu-outcome-relevant-measurement-parameters
#2
E Zeiser
BACKGROUND: Guidelines cannot provide differentiated recommendations for physiotherapy (PT) in intensive care medicine. Scientific publications for PT in the intensive care unit (ICU) usually only have low levels of evidence and often express safety and feasibility of PT in the ICU. OBJECTIVE: Which measurement parameters are relevant for defining outcome and what interventions should one take into consideration? MATERIALS AND METHODS: A literature review was conducted...
January 23, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28075178/the-scope-of-physiotherapy-services-provided-in-public-icus-in-greece-a-pilot-study
#3
Eirini Grammatopoulou, Theodoros N Charmpas, Eftychia G Strati, Tsamis Nikolaos, Afroditi Evagelodimou, Vlassia Belimpasaki, Emmanouil K Skordilis
The aim of the present study was to determine the scope of physiotherapy services provided in Greek ICUs in Athens. A cross-sectional study was conducted with two postal questionnaires administered separately, one for ICU directors and one for ICU physiotherapists. Responses were received from 19 ICU directors and 103 physiotherapists employed in all the adult public mixed medical and surgical ICUs across Athens. The response rate for the survey completion was 100% for ICU directors and 68.7% for physiotherapists...
February 2017: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/28065165/whole-body-vibration-to-prevent-intensive-care-unit-acquired-weakness-safety-feasibility-and-metabolic-response
#4
Tobias Wollersheim, Kurt Haas, Stefan Wolf, Knut Mai, Claudia Spies, Elisabeth Steinhagen-Thiessen, Klaus-D Wernecke, Joachim Spranger, Steffen Weber-Carstens
BACKGROUND: Intensive care unit (ICU)-acquired weakness in critically ill patients is a common and significant complication affecting the course of critical illness. Whole-body vibration is known to be effective muscle training and may be an option in diminishing weakness and muscle wasting. Especially, patients who are immobilized and not available for active physiotherapy may benefit. Until now whole-body vibration was not investigated in mechanically ventilated ICU patients. We investigated the safety, feasibility, and metabolic response of whole-body vibration in critically ill patients...
January 9, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28061873/prophylactic-melatonin-for-delirium-in-intensive-care-pro-medic-study-protocol-for-a-randomised-controlled-trial
#5
F Eduardo Martinez, Matthew Anstey, Andrew Ford, Brigit Roberts, Miranda Hardie, Robert Palmer, Lynn Choo, David Hillman, Michael Hensley, Erin Kelty, Kevin Murray, Bhajan Singh, Bradley Wibrow
BACKGROUND: Delirium is an acute state of brain dysfunction characterised by fluctuating inattention and cognitive disturbances, usually due to illness. It occurs commonly in the intensive care unit (ICU), and it is associated with greater morbidity and mortality. It is likely that disturbances of sleep and of the day-night cycle play a significant role. Melatonin is a naturally occurring, safe and cheap hormone that can be administered to improve sleep. The main aim of this trial will be to determine whether prophylactic melatonin administered to critically ill adults, when compared with placebo, decreases the rate of delirium...
January 6, 2017: Trials
https://www.readbyqxmd.com/read/27984229/sedation-after-cardiac-surgery-is-one-drug-better-than-another
#6
Hong Liu, Fuhai Ji, Ke Peng, Richard L Applegate, Neal Fleming
The classic high-dose narcotic-based cardiac anesthetic has been modified to facilitate a fast-track, rapid recovery in the intensive care unit (ICU). Postoperative sedation is consequently now an essential component in recovery of the patient undergoing cardiac surgery. It must facilitate the patient's unawareness of the environment as well as reduce the discomfort and anxiety caused by surgery, intubation, mechanical ventilation, suction, and physiotherapy. Benzodiazepines seem well suited for this role, but propofol, opioids, and dexmedetomidine are among other agents commonly used for sedation in the ICU...
December 15, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27909374/cardiorespiratory-physiotherapy-around-the-clock-experience-at-a-university-hospital
#7
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
https://www.readbyqxmd.com/read/27898220/intensive-care-physiotherapy-during-extracorporeal-membrane-oxygenation-for-acute-respiratory-distress-syndrome
#8
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 patients with ARDS supported with ECMO, as well as to evaluate the association of this therapeutic modality with mortality. METHODS: We conducted a retrospective cohort study of all adult patients with ARDS supported with ECMO at our institution between 2010 and 2015...
February 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27881152/fitness-and-mobility-training-in-patients-with-intensive-care-unit-acquired-muscle-weakness-fitonicu-study-protocol-for-a-randomised-controlled-trial
#9
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
https://www.readbyqxmd.com/read/27603948/-effects-of-vibrax-mechanical-vibrations-on-the-arterial-blood-gases-of-patients-in-the-intensive-care-unit-after-cardiac-surgery
#10
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
https://www.readbyqxmd.com/read/27447483/effectiveness-of-a-very-early-stepping-verticalization-protocol-in-severe-acquired-brain-injured-patients-a-randomized-pilot-study-in-icu
#11
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
https://www.readbyqxmd.com/read/27445542/what-is-the-best-pulmonary-physiotherapy-method-in-icu
#12
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
https://www.readbyqxmd.com/read/27381171/epidural-analgesia-combined-with-a-comprehensive-physiotherapy-program-after-cytoreductive-surgery-and-hipec-is-associated-with-enhanced-post-operative-recovery-and-reduces-intensive-care-unit-stay-a-retrospective-study-of-124-patients
#13
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...
December 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27367877/effect-of-a-primary-care-management-intervention-on-mental-health-related-quality-of-life-among-survivors-of-sepsis-a-randomized-clinical-trial
#14
RANDOMIZED CONTROLLED TRIAL
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
https://www.readbyqxmd.com/read/27307746/mobilization-of-intensive-care-patients-a-multidisciplinary-practical-guide-for-clinicians
#15
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
https://www.readbyqxmd.com/read/27177013/a-regional-cohort-study-of-the-treatment-of-critically-ill-children-with-bronchiolitis
#16
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
https://www.readbyqxmd.com/read/27105830/clinicians-perceptions-of-rationales-for-rehabilitative-exercise-in-a-critical-care-setting-a-cross-sectional-study
#17
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
https://www.readbyqxmd.com/read/27076708/physiotherapy-practice-patterns-in-intensive-care-units-of-nepal-a-multicenter-survey
#18
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
https://www.readbyqxmd.com/read/27059469/cycle-pilot-a-protocol-for-a-pilot-randomised-study-of-early-cycle-ergometry-versus-routine-physiotherapy-in-mechanically-ventilated-patients
#19
RANDOMIZED CONTROLLED TRIAL
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
https://www.readbyqxmd.com/read/26957715/postoperative-pulmonary-complication-after-neurosurgery-a-case-of-unilateral-lung-collapse
#20
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
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