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rehabilitation in critical illness

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https://www.readbyqxmd.com/read/29331668/earlier-and-enhanced-rehabilitation-of-mechanically-ventilated-patients-in-critical-care-a-feasibility-randomised-controlled-trial
#1
David McWilliams, Charlotte Jones, Gemma Atkins, James Hodson, Tony Whitehouse, Tonny Veenith, Emma Reeves, Lauren Cooper, Catherine Snelson
BACKGROUND: Systematic reviews of early rehabilitation within intensive care units have highlighted the need for robust multi-centre randomised controlled trials with longer term follow up. This trial aims to explore the feasibility of earlier and enhanced rehabilitation for patients mechanically ventilated for ≥5days and to assess the impact on possible long term outcome measures for use in a definitive trial. METHODS: Patients admitted to a large UK based intensive care unit and invasively ventilated for ≥5days were randomised to the rehabilitation intervention or standard care on a 1:1 basis, stratified by age and SOFA score...
January 4, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29319723/characteristics-and-outcomes-of-intensive-care-unit-survivors-experience-of-a-multidisciplinary-outpatient-clinic-in-a-teaching-hospital
#2
Péricles A D Duarte, Jaquilene Barreto Costa, Silvana Trilo Duarte, Sheila Taba, Claudia Regina Felicetti Lordani, Erica Fernanda Osaku, Claudia Rejane Lima Macedo Costa, Dalas Cristina Miglioranza, Daniela Prochnow Gund, Amaury Cesar Jorge
OBJECTIVES: To describe the experience of an outpatient clinic with the multidisciplinary evaluation of intensive care unit survivors and to analyze their social, psychological, and physical characteristics in a low-income population and a developing country. METHODS: Retrospective cohort study. Adult survivors from a general intensive care unit were evaluated three months after discharge in a post-intensive care unit outpatient multidisciplinary clinic over a period of 6 years (2008-2014) in a University Hospital in southern Brazil...
December 2017: Clinics
https://www.readbyqxmd.com/read/29276219/indirect-calorimetry-measurement-of-energy-expenditure-related-to-body-position-changes-in-healthy-adults
#3
Kengo Obata, Tetsuya Yumoto, Soichiro Fuke, Kohei Tsukahara, Hiromichi Naito, Atsuyoshi Iida, Tetsuya Takahashi, Yoshihito Ujike, Atsunori Nakao
Early mobilization is advocated to prevent intensive care unit-acquired physical weakness, but the patient's workload and its changes in response to body position changes have not been established. We used indirect calorimetry to determine the energy expenditure (EE) in response to body position changes, and we assessed EE's correlation with respiratory parameters in healthy volunteers: 8 males and 8 females, mean age 23.4±1.3 years. The subjects started in the resting supine position followed by a 30° head-up position, a 60° head-up position, an upright sitting position, a standing position, and the resting supine position...
December 2017: Acta Medica Okayama
https://www.readbyqxmd.com/read/29251709/benchmarking-clinical-outcomes-and-the-immunocatabolic-phenotype-of-chronic-critical-illness-after-sepsis-in-surgical-intensive-care-unit-patients
#4
Julie A Stortz, Juan C Mira, Steven L Raymond, Tyler J Loftus, Tezcan Ozrazgat-Baslanti, Zhongkai Wang, Gabriela L Ghita, Christiaan Leeuwenburgh, Mark S Segal, Azra Bihorac, Babette A Brumback, Alicia M Mohr, Philip A Efron, Lyle L Moldawer, Frederick A Moore, Scott C Brakenridge
BACKGROUND: A growing number of patients survive sepsis but remain chronically critically ill. We sought to define clinical outcomes and incidence of chronic critical illness (CCI) after sepsis and to determine whether selected biomarkers of inflammation, immunosuppression, and catabolism differ between these patients and those that rapidly recover (RAP). METHODS: This three-year prospective observational cohort study (NCT02276417) evaluated 145 surgical intensive care unit patients with sepsis for the development of CCI (≥14 days of ICU resource utilization with persistent organ dysfunction)...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29249784/-surgical-embolectomy-for-acute-massive-pulmonary-thromboembolism-requiring-percutaneous-cardiopulmonary-support-after-thoracoabdominal-aorta-replacement
#5
Takahiko Masuda, Masaki Hata, Kazuhiro Yamaya, Tomoyuki Suzuki, Yukihiro Hayatsu, Kyohei Ueno, Masaaki Naganuma, Naoya Terao
A 48-year-old man was admitted to our hospital and underwent thoracoabdominal aorta replacement. Eight days postoperatively, he developed severe dyspnea and transient drop in blood pressure suddenly following walk rehabilitation. Contrast-enhanced computed tomography showed thrombi in the bilateral main pulmonary artery. Respiratory failure and unstable hemodynamics developed, which required percutaneous cardiopulmonary support (PCPS). Because catheter embolectomy and thrombolytic therapy via pulmonary artery catheter were not effective, surgical thrombectomy was performed...
December 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29232263/can-the-critically-ill-patient-generate-sufficient-energy-to-facilitate-exercise-in-the-icu
#6
Danielle E Bear, Selina M Parry, Zudin A Puthucheary
PURPOSE OF REVIEW: Trials of physical rehabilitation post critical illness have yet to deliver improved health-related quality of life in critical illness survivors. Muscle mass and strength are lost rapidly in critical illness and a proportion of patients continue to do so resulting in increased mortality and functional disability. Addressing this issue is therefore fundamental for recovery from critical illness. RECENT FINDINGS: Altered mitochondrial function occurs in the critically ill and is likely to result in decreased adenosine tri-phosphate (ATP) production...
December 9, 2017: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/29227709/a-review-study-on-the-beneficial-effects-of-baduanjin
#7
Liye Zou, Zhujun Pan, Albert Yeung, Saira Talwar, Chaoyi Wang, Yang Liu, Yankai Shu, Xiaoan Chen, Garrett Anthony Thomas
AIM: Baduanjin, a Chinese traditional Qigong exercise that focuses on a mind-body integration, is considered to be an effective exercise in promoting health. Thus, we systematically and critically evaluated the emerging literature relating to the effects of Baduanjin on health outcomes. METHODS: We used seven English-language electronic databases for the literature search. At least one health-related parameter was reported in retrievable full-text Baduanjin intervention studies...
December 11, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/29128195/-what-support-of-young-presenting-a-first-psychotic-episode-when-schooling-is-being-challenged
#8
M-N Vacheron, H Veyrat-Masson, E Wehbe
Psychiatric disorders (more specifically mood disorders and psychosis) represent the 1st cause of disability among young people. Unemployment rate between 75 to 95% for the person with schizophrenia. It is correlated to poor social integration and bad economic status, worse symptomatology loss of autonomy as well as global bad functioning. It is responsible of more than half of the overall cost of psychosis. The onset of most of psychiatric disorders occur between the age of 25 and 35 years old, a critical time in young adult life when they should build their professional as well as social future...
November 8, 2017: L'Encéphale
https://www.readbyqxmd.com/read/29099454/early-rehabilitation-a-path-toward-optimizing-function-while-treating-critical-illness-in-children
#9
Amy Houtrow
No abstract text is available yet for this article.
November 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29095167/feasibility-of-early-motor-assisted-upper-extremity-cycle-ergometry-in-critically-ill-neurological-patients-with-upper-extremity-weakness-and-variable-cognitive-status-a-case-series
#10
S Deluzio, I Vora, S Kumble, E K Zink, R D Stevens, M N Bahouth
Upper extremity paresis, common in many neurological conditions, is a major contributor of long-term disability and decreased quality of life. Evidence shows that repetitive, bilateral arm movement improves upper extremity coordination after neurological injury. However, it is difficult to integrate upper extremity interventions into very early rehabilitation of critically ill neurological patients due to patient arousal and medical acuity. This report describes the safety and feasibility of bilateral upper extremity cycling in critically ill neurological patients with bilateral or unilateral paresis...
October 31, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29062760/the-experiences-and-challenges-faced-by-rehabilitation-community-service-therapists-within-the-south-african-primary-healthcare-health-system
#11
Lieketseng Ned, Lizahn Cloete, Gubela Mji
BACKGROUND: Twenty-two years after the promulgation of a plethora of progressive health policies since 1994, the South African public health system reflects a number of stumbling blocks regarding implementation. Rehabilitation professionals are not sufficiently equipped nor allowed the opportunity to comprehensively implement Primary Healthcare (PHC) from a bottom-up approach, thus engaging communities. Training on addressing social health determinants and their impact on ill-health and health outcomes is inadequate...
2017: African Journal of Disability
https://www.readbyqxmd.com/read/29054691/impact-of-critical-illness-polyneuromyopathy-in-rehabilitation-a-prospective-observational-study
#12
Cameron Cunningham, Heather C Finlayson, William R Henderson, Russell J O'Connor, Andrew Travlos
BACKGROUND: Critical illness polyneuromyopathy (CIPNM) increasingly is 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 18, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28991149/decisional-informatics-for-psychosocial-rehabilitation-a-feasibility-pilot-on-tailored-and-fluid-treatment-algorithms-for-serious-mental-illness
#13
RANDOMIZED CONTROLLED TRIAL
Jimmy Choi, Paul H Lysaker, Morris D Bell, Lisa Dixon, Paul Margolies, Matthew Gold, Elizabeth Golden-Roose, Warren Thime, Lawrence C Haber, Michael J Dewberry, Michael Stevens, Godfrey D Pearlson, Joanna M Fiszdon
This study introduces a computerized clinical decision-support tool, the Fluid Outpatient Rehabilitation Treatment (FORT), that incorporates individual and ever-evolving patient needs to guide clinicians in developing and updating treatment decisions in real-time. In this proof-of-concept feasibility pilot, FORT was compared against traditional treatment planning using similar behavioral therapies in 52 adults with severe mental illness attending community-based day treatment. At posttreatment and follow-up, group differences and moderate-to-large effect sizes favoring FORT were detected in social function, work readiness, self-esteem, working memory, processing speed, and mental flexibility...
November 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/28978333/evaluating-physical-functioning-in-critical-care-considerations-for-clinical-practice-and-research
#14
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/28930814/neurologic-and-functional-morbidity-in-critically-ill-children-with-bronchiolitis
#15
Steven L Shein, Katherine N Slain, Jason A Clayton, Bryan McKee, Alexandre T Rotta, Deanne Wilson-Costello
OBJECTIVES: Neurologic and functional morbidity occurs in ~30% of PICU survivors, and young children may be at particular risk. Bronchiolitis is a common indication for PICU admission among children less than 2 years old. Two single-center studies suggest that greater than 10-25% of critical bronchiolitis survivors have neurologic and functional morbidity but those estimates are 20 years old. We aimed to estimate the burden of neurologic and functional morbidity among more recent bronchiolitis patients using two large, multicenter databases...
September 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28930813/temporal-changes-in-prescription-of-neuropharmacologic-drugs-and-utilization-of-resources-related-to-neurologic-morbidity-in-mechanically-ventilated-children-with-bronchiolitis
#16
Steven L Shein, Katherine Slain, Deanne Wilson-Costello, Bryan McKee, Alexandre T Rotta
OBJECTIVES: Critically ill children with bronchiolitis may require neuropharmacologic medications and support for neuro-functional sequelae, but current practices are not well described. We aimed to describe recent trends in neuropharmacology and utilization of neuro-rehabilitation resources in mechanically ventilated children with bronchiolitis. DESIGN: Analysis of the multicenter Pediatric Health Information System database. SETTING: Forty-seven U...
September 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28837430/the-epidemiology-of-chronic-critical-illness-after-severe-traumatic-injury-at-two-level-one-trauma-centers
#17
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...
December 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28820799/regional-anesthesia-and-analgesia-after-surgery-in-icu
#18
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/28814998/correction-to-tsavourelou-a-stylianides-n-papadopoulos-a-dikaiakos-m-d-nanas-s-kyprianou-t-tokmakidis-s-p-2016-telerehabilitation-solution-conceptual-paper-for-community-based-exercise-rehabilitation-of-patients-discharged-after-critical-illness-international
#19
https://www.readbyqxmd.com/read/28780504/intensive-versus-standard-physical-rehabilitation-therapy-in-the-critically-ill-epicc-a-multicentre-parallel-group-randomised-controlled-trial
#20
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
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