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Rehabilitation in ICU

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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/28988400/left-ventricle-assist-devices-and-driveline-s-infection-incidence-a-single-centre-experience
#2
Jonida Bejko, Francesca Toto, Dario Gregori, Gino Gerosa, Tomaso Bottio
Different left ventricular assist devices (LVADs) are provided of different driveline exit sites: HeartWare HVAD presents abdominal power-cable-supply, while the Jarvik 2000 LVAD is powered by a retroauricular driveline. We analyzed 93 LVAD-implanted patients from January-2009 to October-2016 (41 HeartWare and 52 Jarvik 2000), hypothesizing a different incidence of infection, according to driveline exit site. The two populations were propensity matched for the demographic data and preoperative variables, and the outcomes were further analyzed...
October 7, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
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/28956630/dynamics-of-clinical-recovery-during-the-early-phase-of-rehabilitation-in-patients-with-severe-traumatic-and-non-traumatic-brain-injury
#4
Lydia Oujamaa, Gilles Francony, Perrine Boucheix, Clotilde Schilte, Pierre Bouzat, Dominic Perennou, Jean-Francois Payen
PURPOSE: Our aim was to describe the changes in the functional outcome at the early phase of rehabilitation following severe brain injury and to identify the factors associated with faster recovery. METHODS: This retrospective analysis included 182 patients who were transferred from the intensive care unit (ICU) to a post-ICU neurorehabilitation unit following traumatic brain injury (TBI) (n = 82) or cerebrovascular accident (CVA) (n = 100). Admission, discharge and changes in scores were calculated for the Functional Independent Measurement (FIM) and the Wessex Head Injury Matrix (WHIM)...
September 28, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28912876/effect-of-intercostal-nerve-block-combined-with-general-anesthesia-on-the-stress-response-in-patients-undergoing-minimally-invasive-mitral-valve-surgery
#5
Yanping Zhan, Guo Chen, Jian Huang, Benchao Hou, Weicheng Liu, Shibiao Chen
The aim of the present study was to investigate the effect of intercostal nerve block combined with general anesthesia on the stress response and postoperative recovery in patients undergoing minimally invasive mitral valve surgery (MIMVS). A total of 30 patients scheduled for MIMVS were randomly divided into two groups (n=15 each): Group A, which received intercostal nerve block combined with general anesthesia and group B, which received general anesthesia alone. Intercostal nerve block in group A was performed with 0...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28899584/evaluating-the-past-to-improve-the-future-a-qualitative-study-of-icu-patients-experiences
#6
Kristin Dahle Olsen, Marit Nester, Britt Sætre Hansen
BACKGROUND: The recovery period for patients who have been in an intensive care unitis often prolonged and suboptimal. Anxiety, depression and post-traumatic stress disorder are common psychological problems. Intensive care staff offer various types of intensive aftercare. Intensive care follow-up aftercare services are not standard clinical practice in Norway. OBJECTIVE: The overall aim of this study is to investigate how adult patients experience theirintensive care stay their recovery period, and the usefulness of an information pamphlet...
September 9, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28899285/predicting-rehabilitation-length-of-stay-in-canada-it-s-not-just-about-impairment
#7
B Catharine Craven, Dilnur Kurban, Farnoosh Farahani, Carly S Rivers, Chester Ho, A Gary Linassi, Dany H Gagnon, Colleen O'Connell, Karen Ethans, Laurent J Bouyer, Vanessa K Noonan
INTRODUCTION: Current tertiary Spinal Cord Injury (SCI) rehabilitation funding and rehabilitation length of stay (R-LOS) in most North American jurisdictions are linked to an individual's impairment. Our objectives were to: 1) describe the impact of relevant demographic, impairment and medical complexity variables at rehabilitation admission on R-LOS among adult Canadians with traumatic SCI; and 2) identify factors which extend R-LOS. METHODS: Data from 1,376 adults with traumatic SCI were obtained via chart abstraction and administrative data linkage from 15 Rick Hansen SCI Registry sites (2004-2014)...
September 12, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28861039/intracerebral-hemorrhage-with-intraventricular-extension-getting-the-prognosis-right-early
#8
Christoph Stretz, Catherine Gao, David M Greer, Caitlin Loomis, Emily J Gilmore, Adam J Kundishora, Charles C Matouk, David Y Hwang
BACKGROUND: Early accurate outcome prognostication for patients with intracerebral hemorrhage (ICH) and accompanying intraventricular hemorrhage (IVH) is often challenging (1). Acute hydrocephalus often contributes to a poor clinical exam (2) and can portend significant morbidity and mortality (3). Accordingly, the inpatient neurologist may feel inclined to recommend limitations of care for an ICH patient admitted with a large IVH burden and poor exam. CASE PRESENTATION: We present a patient with significant IVH and minimal ICH who deteriorated rapidly to coma after presentation...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28842731/implementing-early-physical-rehabilitation-and-mobilisation-in-the-icu-institutional-clinician-and-patient-considerations
#9
Selina M Parry, Peter Nydahl, Dale M Needham
No abstract text is available yet for this article.
August 25, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28838900/a-patient-cohort-on-long-term-sequelae-of-sepsis-survivors-study-protocol-of-the-mid-german-sepsis-cohort
#10
André Scherag, Christiane S Hartog, Carolin Fleischmann, Dominique Ouart, Franziska Hoffmann, Christian König, Miriam Kesselmeier, Sandra Fiedler, Monique Philipp, Anke Braune, Cornelia Eichhorn, Christin Gampe, Heike Romeike, Konrad Reinhart
INTRODUCTION: An increasing number of patients survive sepsis; however, we lack valid data on the long-term impact on morbidity from prospective observational studies. Therefore, we designed an observational cohort to quantify mid-term and long-term functional disabilities after intensive care unit (ICU)-treated sepsis. Ultimately, findings for the Mid-German Sepsis Cohort (MSC) will serve as basis for the implementation of follow-up structures for patients with sepsis and help to increase quality of care for sepsis survivors...
August 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28837430/the-epidemiology-of-chronic-critical-illness-after-severe-traumatic-injury-at-two-level-one-trauma-centers
#11
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
#12
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/28780504/intensive-versus-standard-physical-rehabilitation-therapy-in-the-critically-ill-epicc-a-multicentre-parallel-group-randomised-controlled-trial
#13
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
#14
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/28743722/bedside-tracheostomy-on-pediatric-icu-subjects-supported-by-extracorporeal-membrane-oxygenation
#15
Stephanie P Schwartz, Desiree Bonadonna, Matthew G Hartwig, Ira M Cheifetz
BACKGROUND: Tracheostomy facilitates ambulatory extracorporeal membrane oxygenation (ECMO) as a bridge to recovery or lung transplantation in patients with respiratory failure, yet data on this procedure in this population are lacking. This report describes a series of pediatric ICU patients who had a bedside tracheostomy performed while being supported on ECMO and examines the potential impact of this procedure on active rehabilitation and sedation requirements. METHODS: This retrospective case series reviews all patients in the pediatric ICU who received a tracheostomy while being supported on ECMO at a single tertiary care center for the past 3 y...
July 25, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28701197/a-case-of-bowel-perforation-due-to-traumatic-hernia-at-a-pelvic-fracture-site-a-case-report-and-review-of-the-literature
#16
Ryota Tanaka, Hisashi Nagahara, Kiyoshi Maeda, Hiroshi Ohtani, Masatsune Shibutani, Tatsuro Tamura, Tetsuro Ikeya, Kenji Sugano, Yasuhito Iseki, Katsunobu Sakurai, Sadaaki Yamazoe, Kenjiro Kimura, Takahiro Toyokawa, Ryosuke Amano, Naoshi Kubo, Hiroaki Tanaka, Kazuya Muguruma, Kosei Hirakawa, Masaichi Ohira
BACKGROUND: Common complications of pelvic fractures include visceral injury, large-volume hemorrhage, genitourinary injury, rectal injury, and pulmonary embolism. On the other hand, traumatic hernia is a rare complication, especially in association with pelvic fractures. We report a case of bowel perforation due to traumatic hernia at a pelvic fracture site. CASE PRESENTATION: A 65-year-old female was presented at our hospital for further examination and treatment of ileus...
July 12, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28693521/predictors-of-intensive-care-unit-admission-and-mortality-in-patients-with-ischemic-stroke-investigating-the-effects-of-a-pulmonary-rehabilitation-program
#17
Belma Doğan Güngen, Abdulkadir Tunç, Yeşim Güzey Aras, Aslı Aksoy Gündoğdu, Adil Can Güngen, Serdar Bal
BACKGROUND: The aim of this study was to investigate the predictors of intensive care unit (ICU) admission and mortality among stroke patients and the effects of a pulmonary rehabilitation program on stroke patients. METHODS: This prospective study enrolled 181 acute ischemic stroke patients aged between 40 and 90 years. Demographical characteristics, laboratory tests, diffusion-weighed magnetic resonance imaging (DWI-MRI) time, nutritional status, vascular risk factors, National Institute of Health Stroke Scale (NIHSS) scores and modified Rankin scale (MRS) scores were recorded for all patients...
July 11, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28685809/follow-up-after-intensive-care-treatment-a-questionnaire-survey-of-intensive-care-aftercare-in-denmark
#18
C K W Kjer, S Estrup, L M Poulsen, O Mathiesen
BACKGROUND: Rehabilitation efforts after treatment in the intensive care unit (ICU) are termed intensive care aftercare. It includes both early in-hospital follow-up after ICU-discharge and late follow-up after hospital discharge. This study aims to investigate the current ICU-aftercare activities in Denmark. METHODS: We conducted an electronic questionnaire survey, which was distributed by e-mail to the heads of all 31 general ICUs in Denmark. Specialized ICUs were not included...
September 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28675113/low-levels-of-physical-activity-during-critical-illness-and-weaning-the-evidence-reality-gap
#19
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
#20
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
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