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https://www.readbyqxmd.com/read/28428892/a-comparison-of-earlier-and-enhanced-rehabilitation-of-mechanically-ventilated-patients-in-critical-care-compared-to-standard-care-rehab-study-protocol-for-a-single-site-randomised-controlled-feasibility-trial
#1
Catherine Snelson, Charlotte Jones, Gemma Atkins, James Hodson, Tony Whitehouse, Tonny Veenith, David Thickett, Emma Reeves, Aisling McLaughlin, Lauren Cooper, David McWilliams
BACKGROUND: Mortality from critical illness is improving, but survivors suffer from prolonged weakness and psychological and cognitive impairments. Maximising the recovery after critical illness has been highlighted as a research priority, especially in relation to an ageing population who present with higher rates of pre-morbid disability. Small studies have shown that starting rehabilitation early within the intensive care unit (ICU) improves short-term outcomes. Systematic reviews have highlighted the need for robust multicentre randomised controlled trials with longer term follow-up...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28388378/protein-turnover-and-metabolism-in-the-elderly-intensive-care-unit-patient
#2
Stuart M Phillips, Roland N Dickerson, Frederick A Moore, Douglas Paddon-Jones, Peter J M Weijs
Many intensive care unit (ICU) patients do not achieve target protein intakes particularly in the early days following admittance. This period of iatrogenic protein undernutrition contributes to a rapid loss of lean, in particular muscle, mass in the ICU. The loss of muscle in older (aged >60 years) patients in the ICU may be particularly rapid due to a perfect storm of increased catabolic factors, including systemic inflammation, disuse, protein malnutrition, and reduced anabolic stimuli. This loss of muscle mass has marked consequences...
April 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28387014/weak-by-the-machines-muscle-motor-protein-dysfunction-ndash-a-side-effect-of-intensive-care-unit-treatment
#3
REVIEW
O Friedrich, S Diermeier, L Larsson
Intensive care interventions involve periods of mechanical ventilation, sedation and complete mechanical silencing of patients. Critical illness myopathy (CIM) is an ICU-acquired myopathy that is associated with limb muscle weakness, muscle atrophy, electrical silencing of muscle and motor-proteinopathy. The hallmark of CIM is a preferential muscle myosin loss due to increased catabolic and reduced anabolic activity. The ubiquitin-proteasome pathway plays an important role, apart from recently identified novel mechanisms affecting nonlysosomal protein degradation or autophagy...
April 7, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/28382599/diagnostic-accuracy-of-quantitative-neuromuscular-ultrasound-for-the-diagnosis-of-intensive-care-unit-acquired-weakness-a-cross-sectional-observational-study
#4
Esther Witteveen, Juultje Sommers, Luuk Wieske, Jonne Doorduin, Nens van Alfen, Marcus J Schultz, Ivo N van Schaik, Janneke Horn, Camiel Verhamme
BACKGROUND: Neuromuscular ultrasound is a noninvasive investigation, which can be easily performed at the bedside on the ICU. A reduction in muscle thickness and increase in echo intensity over time have been described in ICU patients, but the relation to ICU-acquired weakness (ICU-AW) is unknown. We hypothesized that quantitative assessment of muscle and nerve parameters with ultrasound can differentiate between patients with and without ICU-AW. The aim of this cross-sectional study was to investigate the diagnostic accuracy of neuromuscular ultrasound for diagnosing ICU-AW...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28373296/a-proteomic-approach-to-identify-alterations-in-the-sumo-network-during-controlled-mechanical-ventilation-in-rat-diaphragm-muscle
#5
Arvind Venkat Namuduri, Gabriel Heras, Jia Mi, Nicola Cacciani, Katarina Hörnaeus, Anne Konzer, Sara Bergström Lind, Lars Larsson, Stefano Gastaldello
The Small Ubiquitin-like Modifier (SUMO) is as a regulator of many cellular functions by reversible conjugation to a broad number of substrates. Under endogenous or exogenous perturbations, the SUMO network becomes a fine sensor of stress conditions by alterations in the expression level of SUMO enzymes and consequently changing the status of SUMOylated proteins. The diaphragm is the major inspiratory muscle, which is continuously active under physiological conditions, but its structure and function is severely affected when passively displaced for long extents during mechanical ventilation (MV)...
April 3, 2017: Molecular & Cellular Proteomics: MCP
https://www.readbyqxmd.com/read/28364678/effect-of-neuromuscular-stimulation-and-individualized-rehabilitation-on-muscle-strength-in-intensive-care-unit-survivors-a-randomized-trial
#6
Irini Patsaki, Vasiliki Gerovasili, Georgios Sidiras, Eleftherios Karatzanos, Georgios Mitsiou, Emmanuel Papadopoulos, Anna Christakou, Christina Routsi, Anastasia Kotanidou, Serafim Nanas
PURPOSE: Intensive Care Unit (ICU) survivors experience muscle weakness leading to restrictions in functional ability. Neuromuscular electrical stimulation (NMES) has been an alternative to exercise in critically ill patients. The aim of our study was to investigate its effects along with individualized rehabilitation on muscle strength of ICU survivors. MATERIAL AND METHODS: Following ICU discharge, 128 patients (age: 53±16years) were randomly assigned to daily NMES sessions and individualized rehabilitation (NMES group) or to control group...
March 22, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28361079/ultrasound-to-assess-diaphragmatic-function-in-the-critically-ill-a-critical-perspective
#7
EDITORIAL
Mark Haaksma, Pieter Roel Tuinman, Leo Heunks
Ultrasound of the diaphragm in critically ill patients has become a diagnostic technique of emerging interest among clinicians and scientists. The advantages include that it is widely available, non-invasive and examination can be performed after relatively short training and at low costs. It is used to estimate muscle mass by measurement of muscle thickness and diagnose weakness by the assessment of diaphragm movement during unassisted breathing. Thickening of the muscle during inspiration has been used to quantify force generation...
March 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28350642/increased-early-systemic-inflammation-in-icu-acquired-weakness-a-prospective-observational-cohort-study
#8
Esther Witteveen, Luuk Wieske, Tom van der Poll, Marike van der Schaaf, Ivo N van Schaik, Marcus J Schultz, Camiel Verhamme, Janneke Horn
OBJECTIVES: To investigate whether patients who develop ICU-acquired weakness have a different pattern of systemic inflammatory markers compared with critically ill patients who do not develop ICU-acquired weakness. DESIGN: Prospective observational cohort study. SETTING: Mixed medical-surgical ICU of a tertiary care hospital in the Netherlands. PATIENTS: Newly admitted critically ill patients, greater than or equal to 48 hours on mechanical ventilation with a nonneurologic ICU admission diagnosis, were included...
March 27, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28325097/regaining-water-swallowing-function-in-the-rehabilitation-of-critically-ill-patients-with-intensive-care-unit-acquired-muscle-weakness
#9
Simone Thomas, Wolfgang Sauter, Ulrike Starrost, Marcus Pohl, Jan Mehrholz
PURPOSE: Treatment in intensive care units (ICUs) often results in swallowing dysfunction. Recent longitudinal studies have described the recovery of critically ill people, but we are not aware of studies of the recovery of swallowing function in patients with ICU-acquired muscle weakness. This paper aims to describe the time course of regaining water swallowing function in patients with ICU-acquired weakness in the post-acute phase and to describe the risks of regaining water swallowing function and the risk factors involved...
March 21, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28301864/functional-recovery-in-patients-with-and-without-intensive-care-unit-acquired-weakness
#10
Daniela Susanne Dettling-Ihnenfeldt, Luuk Wieske, Janneke Horn, Frans Nollet, Marike van der Schaaf
OBJECTIVE: The aim of this work was to compare the patient-reported functional health status with regard to physical, psychological, and social functioning of intensive care unit (ICU) survivors with and without ICU-acquired weakness (ICU-AW). DESIGN: Single-center prospective study in ICU patients who were mechanically ventilated for more than 2 days and who survived to ICU discharge. Functional health status was assessed at 3, 6, and 12 months after ICU discharge, using the Sickness Impact Profile 68 (SIP68)...
April 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28289812/the-icm-research-agenda-on-intensive-care-unit-acquired-weakness
#11
Nicola Latronico, Margaret Herridge, Ramona O Hopkins, Derek Angus, Nicholas Hart, Greet Hermans, Theodore Iwashyna, Yaseen Arabi, Giuseppe Citerio, E Wesley Ely, Jesse Hall, Sangeeta Mehta, Kathleen Puntillo, Johannes Van den Hoeven, Hannah Wunsch, Deborah Cook, Claudia Dos Santos, Gordon Rubenfeld, Jean-Louis Vincent, Greet Van den Berghe, Elie Azoulay, Dale M Needham
We present areas of uncertainty concerning intensive care unit-acquired weakness (ICUAW) and identify areas for future research. Age, pre-ICU functional and cognitive state, concurrent illness, frailty, and health trajectories impact outcomes and should be assessed to stratify patients. In the ICU, early assessment of limb and diaphragm muscle strength and function using nonvolitional tests may be useful, but comparison with established methods of global and specific muscle strength and physical function and determination of their reliability and normal values would be important to advance these techniques...
March 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28283700/mechanism-of-icu-acquired-weakness-skeletal-muscle-loss-in-critical-illness
#12
Jane Batt, Margaret Herridge, Claudia Dos Santos
No abstract text is available yet for this article.
March 10, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28283324/early-mobilization-why-what-for-and-how
#13
A R Miranda Rocha, B P Martinez, V Z Maldaner da Silva, L A Forgiarini Junior
Early mobilization strategies in the intensive care unit may result in the prevention and reduction of polyneuromyopathy in the critical patient, improved quality of life, shortened ICU and hospital stay, and lesser mortality during hospitalization. However, it is well known that factors such as the protocol used, the population included in the studies, the timing of the strategy, the severity of the patients and different barriers directly influence the outcomes. This study examines the main protocols described in the literature and their associated results...
March 7, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28255615/mechanism-of-icu-acquired-weakness-muscle-contractility-in-critical-illness
#14
EDITORIAL
Jane Batt, Sunita Mathur, Hans D Katzberg
No abstract text is available yet for this article.
March 3, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28239521/swallowing-and-swallowing-breathing-interaction-as-predictors-of-intubation-in-guillain-barr%C3%A3-syndrome
#15
Adam Ogna, Helene Prigent, Michele Lejaille, Patricia Samb, Tarek Sharshar, Djillali Annane, Frederic Lofaso, David Orlikowski
BACKGROUND: Bulbar weakness and respiratory impairment have been associated with increased morbidity in retrospective studies of Guillain-Barré syndrome (GBS) patients. The aim of this study was to prospectively explore the relationship between subclinical swallowing impairment, respiratory function parameters, the necessity to intubate patients and the development of early postintubation pneumonia in patients with GBS in the intensive care unit (ICU). METHODS: Respiratory, swallowing, and tongue strength parameters were measured in 30 consecutive adults (51...
February 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28210771/factors-influencing-physical-activity-and-rehabilitation-in-survivors-of-critical-illness-a-systematic-review-of-quantitative-and-qualitative-studies
#16
REVIEW
Selina M Parry, Laura D Knight, Bronwen Connolly, Claire Baldwin, Zudin Puthucheary, Peter Morris, Jessica Mortimore, Nicholas Hart, Linda Denehy, Catherine L Granger
PURPOSE: To identify, evaluate and synthesise studies examining the barriers and enablers for survivors of critical illness to participate in physical activity in the ICU and post-ICU settings from the perspective of patients, caregivers and healthcare providers. METHODS: Systematic review of articles using five electronic databases: MEDLINE, CINAHL, EMBASE, Cochrane Library, Scopus. Quantitative and qualitative studies that were published in English in a peer-reviewed journal and assessed barriers or enablers for survivors of critical illness to perform physical activity were included...
February 16, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28190446/prognosis-of-neurologic-complications-in-critical-illness
#17
REVIEW
M Van Der Jagt, E J O Kompanje
Neurologic complications of critical illness require extensive clinical and neurophysiologic evaluation to establish a reliable prognosis. Many sequelae of intensive care unit (ICU) treatment, such as delirium and ICU-acquired weakness, although highly associated with adverse outcomes, are less suitable for prognostication, but should rather prompt clinicians to seek previously unnoticed persisting underlying illnesses. Prognostication can be confounded by drug administration particularly because its clearance is abnormal in critical illness...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28190439/neurologic-complications-of-polytrauma
#18
R M Jha, L Shutter
Neurologic complications in polytrauma can be classified by etiology and clinical manifestations: neurovascular, delirium, and spinal or neuromuscular problems. Neurovascular complications include ischemic strokes, intracranial hemorrhage, or the development of traumatic arteriovenous fistulae. Delirium and encephalopathy have a reported incidence of 67-92% in mechanically ventilated polytrauma patients. Causes include sedation, analgesia/pain, medications, sleep deprivation, postoperative state, toxic ingestions, withdrawal syndromes, organ system dysfunction, electrolyte/metabolic abnormalities, and infections...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28190434/intensive-care-unit-acquired-weakness
#19
J Horn, G Hermans
When critically ill, a severe weakness of the limbs and respiratory muscles often develops with a prolonged stay in the intensive care unit (ICU), a condition vaguely termed intensive care unit-acquired weakness (ICUAW). Many of these patients have serious nerve and muscle injury. This syndrome is most often seen in surviving critically ill patients with sepsis or extensive inflammatory response which results in increased duration of mechanical ventilation and hospital length of stay. Patients with ICUAW often do not fully recover and the disability will seriously impact on their quality of life...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28190429/the-scope-of-neurology-of-critical-illness
#20
REVIEW
E F M Wijdicks
Critical illness increases the probability of a neurologic complication. There are many reasons to consult a neurologist in a critically ill patient and most often it is altered alertness with no intuitive plausible explanation. Other common clinical neurologic problems facing the intensive care specialist and consulting neurologist in everyday decisions are coma following prolonged cardiovascular surgery, newly perceived motor asymmetry, seizures or other abnormal movements, and generalized muscle weakness...
2017: Handbook of Clinical Neurology
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