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Rehabilitation in ICU

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https://www.readbyqxmd.com/read/29658187/overview-of-intensive-care-unit-related-physical-and-functional-impairments-and-rehabilitation-related-devices
#1
REVIEW
Katie Koester, Heidi Troeller, Sara Panter, Emily Winter, Jayshil J Patel
Rehabilitation after critical illness requires a multidisciplinary effort. Nutrition support of critically ill patients aims to correct the imbalance between protein synthesis and protein degradation to maximize strengthening and muscle mass, whereas physical and occupational therapists focus on optimizing strength and mobility through functional activity to help intensive care (ICU) patients return to their precritical illness level of function and improve quality of life. Early mobility has become the new standard of care for ICU patients...
April 2018: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29622692/predicting-risk-of-unplanned-hospital-readmission-in-survivors-of-critical-illness-a-population-level-cohort-study
#2
Nazir I Lone, Robert Lee, Lisa Salisbury, Eddie Donaghy, Pamela Ramsay, Janice Rattray, Timothy S Walsh
BACKGROUND: Intensive care unit (ICU) survivors experience high levels of morbidity after hospital discharge and are at high risk of unplanned hospital readmission. Identifying those at highest risk before hospital discharge may allow targeting of novel risk reduction strategies. We aimed to identify risk factors for unplanned 90-day readmission, develop a risk prediction model and assess its performance to screen for ICU survivors at highest readmission risk. METHODS: Population cohort study linking registry data for patients discharged from general ICUs in Scotland (2005-2013)...
April 5, 2018: Thorax
https://www.readbyqxmd.com/read/29584447/inspiratory-muscle-rehabilitation-in-critically-ill-adults-a-systematic-review-and-meta-analysis
#3
Stefannie Vorona, Umberto Sabatini, Sulaiman Al-Maqbali, Michele Bertoni, Martin Dres, Bernie Bissett, Frank Van Haren, A Daniel Martin, Cristian Urrea, Debbie Brace, Matteo Parotto, Margaret S Herridge, Neill Kj Adhikari, Eddy Fan, Luana T Melo, W Darlene Reid, Laurent J Brochard, Niall D Ferguson, Ewan C Goligher
BACKGROUND: Respiratory muscle weakness is common in critically ill patients; the role of targeted inspiratory muscle training (IMT) in ICU rehabilitation strategies remains poorly defined. OBJECTIVES: The primary objective was to describe the range and tolerability of published methods for IMT. The secondary objectives were to determine whether IMT improves respiratory muscle strength and clinical outcomes in critically ill patients. DATA SOURCES: We conducted a systematic review to identify randomized and non-randomized studies of physical rehabilitation interventions intended to strengthen the respiratory muscles in critically ill adults...
March 27, 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29579311/strength-and-cardiorespiratory-exercise-rehabilitation-for-severely-burned-patients-during-intensive-care-units-a-survey-of-practice
#4
Janos Cambiaso-Daniel, Ingrid Parry, Eric Rivas, Jennifer Kemp-Offenberg, Soman Sen, Julie A Rizzo, Michael A Serghiou, Karen Kowalske, Steven E Wolf, David N Herndon, Oscar E Suman
Minimizing the deconditioning of burn injury through early rehabilitation programs (RP) in the intensive care unit (ICU) is of importance for improving the recovery time. The aim of this study was to assess current standard of care (SOC) for early ICU exercise programs in major burn centers. We designed a survey investigating exercise RP on the ICU for burn patients with >30% total burned surface area. The survey was composed of 23 questions and submitted electronically via SurveyMonkey® to six major (pediatric and adult) burn centers in Texas and California...
March 22, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29551305/dialysis-dependence-predicts-complications-intensive-care-unit-care-length-of-stay-and-skilled-nursing-needs-in-elective-primary-total-knee-and-hip-arthroplasty
#5
Joseph T Patterson, Kyle Tillinghast, Derek Ward
BACKGROUND: Limited data describe risks and perioperative resource needs of total joint arthroplasty (TJA) in dialysis-dependent patients. METHODS: Retrospective multiple cohort analysis of dialysis-dependent American College of Surgeons National Surgical Quality Improvement Program patients undergoing primary elective total hip and knee arthroplasty compared to non-dialysis-dependent controls from 2005 to 2015. Relative risks (RRs) of 30-day adverse events were determined by multivariate regression adjusting for baseline differences...
February 17, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29530090/adherence-to-standardized-assessments-through-a-complexity-based-model-for-categorizing-rehabilitation%C3%A2-design-and-implementation-in-an-acute-hospital
#6
Tania Gutiérrez Panchana, Viviane Hidalgo Cabalín
BACKGROUND: The use of measurement instruments has become a major issue in physical therapy, but their use in daily practice is rare. The aim of this paper is to describe adherence to standardized assessments by physical therapists using a complexity-based model for categorizing rehabilitation (CMCR) at the Clínica Alemana of Santiago, an acute hospital in Chile. METHODS: This retrospective cohort study used 145,968 participant records that were stored in the inpatient database between July 2011 and December 2015...
March 12, 2018: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29521716/interprofessional-care-and-teamwork-in-the-icu
#7
Anne L Donovan, J Matthew Aldrich, A Kendall Gross, Denise M Barchas, Kevin C Thornton, Hildy M Schell-Chaple, Michael A Gropper, Angela K M Lipshutz
OBJECTIVES: We describe the importance of interprofessional care in modern critical care medicine. This review highlights the essential roles played by specific members of the interprofessional care team, including patients and family members, and discusses quality improvement initiatives that require interprofessional collaboration for success. DATA SOURCES: Studies were identified through MEDLINE search using a variety of search phrases related to interprofessional care, critical care provider types, and quality improvement initiatives...
March 7, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29505152/early-protein-inadequacy-is-associated-with-longer-intensive-care-unit-stay-and-fewer-ventilator-free-days-a-retrospective-analysis-of-patients-with-prolonged-surgical-intensive-care-unit-stay
#8
D Dante Yeh, Eva Fuentes, Sadeq A Quraishi, Jarone Lee, Haytham M A Kaafarani, Peter Fagenholz, Kathryn Butler, Marc DeMoya, Yuchiao Chang, George Velmahos
BACKGROUND: Failure to provide adequate nutrition in the intensive care unit (ICU) may be particularly harmful for patients with prolonged critical illness. We hypothesized that early nutrition inadequacy is more influential for those requiring a longer ICU stay versus those requiring a shorter stay. METHODS: We enrolled 280 adult patients with prolonged surgical ICU stay who were receiving enteral nutrition for >72 hours. Subjects were divided into 2 groups: shortICU (<14 days) and longICU (≥14 days)...
January 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29484188/the-safety-of-a-novel-early-mobilization-protocol-conducted-by-icu-physicians-a-prospective-observational-study
#9
Keibun Liu, Takayuki Ogura, Kunihiko Takahashi, Mitsunobu Nakamura, Hiroaki Ohtake, Kenji Fujiduka, Emi Abe, Hitoshi Oosaki, Dai Miyazaki, Hiroyuki Suzuki, Mitsuaki Nishikimi, Alan Kawarai Lefor, Takashi Mato
Background: There are numerous barriers to early mobilization (EM) in a resource-limited intensive care unit (ICU) without a specialized team or an EM culture, regarding patient stability while critically ill or in the presence of medical devices. We hypothesized that ICU physicians can overcome these barriers. The aim of this study was to investigate the safety of EM according to the Maebashi EM protocol conducted by ICU physicians. Methods: This was a single-center prospective observational study...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29463382/clinical-and-non-clinical-factors-that-predict-discharge-disposition-after-a-fall
#10
Melissa K James, R Jonathan Robitsek, Syed M Saghir, Patricia A Gentile, Marylin Ramos, Frances Perez
BACKGROUND: Falls can result in injuries that require rehabilitation and long-term care after hospital discharge. Identifying factors that contribute to prediction of discharge disposition is crucial for efficient resource utilization and reducing cost. Several factors may influence discharge location after hospitalization for a fall. The aim of this study was to examine clinical and non-clinical factors that may predict discharge disposition after a fall. We hypothesized that age, injury type, insurance type, and functional status would affect discharge location...
February 14, 2018: Injury
https://www.readbyqxmd.com/read/29463245/fatigue-in-chronically-critically-ill-patients-following-intensive-care-reliability-and-validity-of-the-multidimensional-fatigue-inventory-mfi-20
#11
Gloria-Beatrice Wintermann, Jenny Rosendahl, Kerstin Weidner, Bernhard Strauß, Andreas Hinz, Katja Petrowski
BACKGROUND: Fatigue often occurs as long-term complication in chronically critically ill (CCI) patients after prolonged intensive care treatment. The Multidimensional Fatigue Inventory (MFI-20) has been established as valid instrument to measure fatigue in a wide range of medical illnesses. Regarding the measurement of fatigue in CCI patients, the psychometric properties of the MFI-20 have not been investigated so far. Thus, the present study examines reliability and validity of the MFI-20 in CCI patients...
February 20, 2018: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/29456690/protective-effects-of-recombinant-human-brain-natriuretic-peptide-in-perioperative-period-during-open-heart-surgery
#12
Yunbin Xu, Yong Li, Weiguo Bao, Shi Qiu
The aim of the present study was to evaluate the protective effects and safety aspects of recombinant human brain natriuretic peptide (rhBNP) on cardiac functions of patients undergoing open-heart surgery during perioperative period. In total, 150 patients undergoing open heart surgery in the Second Hospital of Shandong Universty from August 2015 to July 2016 were randomly divided into control group and observation group each with 75 cases. Patients in control group were treated by routine rehabilitation while patients in the observation group were treated by both the routine rehabilitation and rhBNP...
March 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29455923/prevalence-location-and-characteristics-of-chronic-pain-in-intensive-care-survivors
#13
Anne Kathrine Langerud, Tone Rustøen, Cathrine Brunborg, Ulf Kongsgaard, Audun Stubhaug
A growing number of studies have addressed the long-term consequences of intensive care unit (ICU) treatment, but few have studied the prevalence of chronic pain and pain characteristics longitudinally. The goal of the work described here was to investigate the prevalence and characteristics of chronic pain in ICU survivors 3 months and 1 year after ICU discharge and to identify risk factors for chronic pain 1 year after ICU discharge. The design used was an explorative and longitudinal study. The patients in this work had stayed >48 hours in two mixed ICUs in Oslo University Hospital, a tertiary referral hospital...
February 15, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29430447/mechanisms-involved-in-brain-dysfunction-in-mechanically-ventilated-critically-ill-patients-implications-and-therapeutics
#14
REVIEW
Marc Turon, Sol Fernández-Gonzalo, Candelaria de Haro, Rudys Magrans, Josefina López-Aguilar, Lluís Blanch
Critical illness may lead to significant long-term neurological morbidity and patients frequently develop neuropsychological disturbances including acute delirium or memory impairment after intensive care unit (ICU) discharge. Mechanical ventilation (MV) is a risk factor to the development of adverse neurocognitive outcomes. Patients undergoing MV for long periods present neurologic impairment with memory and cognitive alteration. Delirium is considered an acute form of brain dysfunction and its prevalence rises in mechanically ventilated patients...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29430446/models-of-disuse-muscle-atrophy-therapeutic-implications-in-critically-ill-patients
#15
REVIEW
Esther Barreiro
Skeletal muscle weakness is common in the intensive care units (ICU). Approximately 50% of patients under mechanical ventilation for more than 7 days show signs of ICU-acquired muscle weakness. In these patients, muscle weakness may be the result of axonal polyneuropathy, myopathy or a combination of both. The commonest risk factors in patients with ICU-acquired weakness (AW) are the severity and duration of the systemic inflammatory response, duration of the stay in the ICU and of mechanical ventilation, hyperglycemia, hypoalbuminemia, parenteral nutrition, and administration of corticosteroids and of neuromuscular blocking agents...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29403646/barriers-and-facilitators-to-early-rehabilitation-in-mechanically-ventilated-patients-a-theory-driven-interview-study
#16
Shannon L Goddard, Fabiana Lorencatto, Ellen Koo, Louise Rose, Eddy Fan, Michelle E Kho, Dale M Needham, Gordon D Rubenfeld, Jill J Francis, Brian H Cuthbertson
Background: Despite a supportive evidence base and a push to implement, the uptake of early rehabilitation in critical care has been inconsistent. The objective of this study was to explore barriers and facilitators to early rehabilitation for critically ill patients receiving invasive mechanical ventilation. Methods: Using the Theoretical Domains Framework (TDF) of behavior change, we conducted semi-structured interviews exploring barriers and facilitators to early rehabilitation among four purposively sampled ICU clinician groups (nurses, rehabilitation professionals, respiratory therapists, and physicians)...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29397452/update-on-the-treatment-of-spontaneous-intraparenchymal-hemorrhage-medical-and-interventional-management
#17
REVIEW
Thomas J Cusack, J Ricardo Carhuapoma, Wendy C Ziai
PURPOSE OF REVIEW: Spontaneous intraparenchymal hemorrhage (IPH) is a prominent challenge faced globally by neurosurgeons, neurologists, and intensivists. Over the past few decades, basic and clinical research efforts have been undertaken with the goal of delineating biologically and evidence-based practices aimed at decreasing mortality and optimizing the likelihood of meaningful functional outcome for patients afflicted with this devastating condition. Here, the authors review the medical and surgical approaches available for the treatment of spontaneous intraparenchymal hemorrhage, identifying areas of recent progress and ongoing research to delineate the scope and scale of IPH as it is currently understood and treated...
February 3, 2018: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/29394221/functional-recovery-in-critically-ill-children-the-weecover-multicenter-study
#18
Karen Choong, Douglas Fraser, Samah Al-Harbi, Asm Borham, Jill Cameron, Saoirse Cameron, Ji Cheng, Heather Clark, Tim Doherty, Nora Fayed, Jan-Willem Gorter, Margaret Herridge, Mary Khetani, Kusum Menon, Jamie Seabrook, Racquel Simpson, Lehana Thabane
OBJECTIVES: To evaluate functional outcomes and evaluate predictors of an unfavorable functional outcome in children following a critical illness. DESIGN: Prospective observational longitudinal cohort study. SETTING: Two tertiary care, Canadian PICUs: McMaster Children's Hospital and London Health Sciences. PATIENTS: Children 12 months to 17 years old, admitted to PICU for at least 48 hours with one or more organ dysfunction, were eligible...
February 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29372070/a-feasibility-study-of-a-randomised-controlled-trial-to-examine-the-impact-of-the-abcde-bundle-on-quality-of-life-in-icu-survivors
#19
Kellie Sosnowski, Marion L Mitchell, Hayden White, Lynette Morrison, Joanne Sutton, Jessica Sharratt, Frances Lin
Background: Early rehabilitation has been found to prevent delirium and weakness that can hamper the recovery of intensive care unit (ICU) survivors. Integrated clinical practice guidelines for managing patient pain, agitation and delirium (PAD) have been developed. The Awakening and Breathing Coordination, Delirium monitoring/management, and Early exercise/mobility (ABCDE) bundle provides a strategy to implement PAD guidelines into everyday clinical practice. However, there is limited evidence on the effectiveness of the ABCDE bundle in the literature...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29357778/normal-baseline-function-is-associated-with-delayed-rehabilitation-in-critically-ill-children
#20
Shinya Miura, Beth Wieczorek, Hallie Lenker, Sapna R Kudchadkar
BACKGROUND: Early mobilization of patients in the adult intensive care unit (ICU) is associated with improved functional outcomes and shorter ICU stay. Although emerging evidence suggests that early mobilization in pediatric ICUs (PICUs) is safe and feasible, physical therapist (PT) consultation may be delayed because of perceptions that patient acuity precludes mobilization activities. Factors that influence timely involvement of PTs to facilitate acute rehabilitation in critically ill children have not been characterized...
January 1, 2018: Journal of Intensive Care Medicine
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