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https://www.readbyqxmd.com/read/28643814/-unresponsive-wakefulness-syndrome-clinical-predictors-of-late-recovery
#1
Gianfranco Lamberti, Elena Antoniono, Francesca Gozzerino, Donatella Giraudo
Patients affected by the outcomes of serious traumatic and/or non-traumatic brain injury may show progressive recovery characterized by a broad spectrum of clinical conditions, which are often not completely different, but of differing seriousness. The unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS) are syndromes that may characterize progression from the coma state and may be temporary clinical conditions, or in some cases, the final outcome of acute brain injury. The eventual recovery of consciousness is a dynamic process, in constant progress following the acute event...
May 2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/28635194/volitional-rehabilitative-assessments-in-patients-admitted-in-a-post-intensive-care-step-down-unit-a-feasibility-study
#2
Mara Paneroni, Francesco D' Abrosca, Georges Fokom, Laura Comini, Michele Vitacca
A high variability in functional tests and activities used during the pulmonary rehabilitation has been observed in post-intensive care unit (ICU) patients, and the best battery of tests to adopt has not been described yet. We tested in patients admitted in a post-ICU Step Down Unit the ability to perform the more frequent functional volitional tests. The relations of each single volitional test with general disability and dyspnea at discharge were also evaluated. Ten volitional tests including: bedside spirometry test (ST: FEV1%, FVC%), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), Peak Expiratory Flow during Cough (PCEF), Quadriceps Muscle Strength (QMS), latissimus Dorsi and teres Major Strength (DMS), Brachial biceps Muscle Strength (BMS), effort tolerance measured by sit-to-stand test, Takahashi test and 6-Min Walking Test (6MWT), were evaluated in post-ICU patients at entry and discharge from in-hospital rehabilitation...
May 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28608135/can-proportional-ventilation-modes-facilitate-exercise-in-critically-ill-patients-a-physiological-cross-over-study-pressure-support-versus-proportional-ventilation-during-lower-limb-exercise-in-ventilated-critically-ill-patients
#3
Evangelia Akoumianaki, Nicolas Dousse, Aissam Lyazidi, Jean-Claude Lefebvre, Severine Graf, Ricardo Luiz Cordioli, Nathalie Rey, Jean-Christophe Marie Richard, Laurent Brochard
BACKGROUND: Early exercise of critically ill patients may have beneficial effects on muscle strength, mass and systemic inflammation. During pressure support ventilation (PSV), a mismatch between demand and assist could increase work of breathing and limit exercise. A better exercise tolerance is possible with a proportional mode of ventilation (Proportional Assist Ventilation, PAV+ and Neurally Adjusted Ventilatory Assist, NAVA). We examined whether, in critically ill patients, PSV and proportional ventilation have different effects on respiratory muscles unloading and work efficiency during exercise...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28604379/physiotherapy-immediately-after-thymectomy-in-patients-with-myasthenia-gravis-two-cases-and-review-of-the-literature
#4
Massimiliano Polastri, Franco Stella, Massimo Lambertini, Walter Trani, Annalisa Ghetti, Andrea Dell'Amore
AIM: Myasthenia gravis (MG) is a rare autoimmune disease characterized by activation of autoantibodies against acetylcholine receptors: patients with MG typically experience muscle weakness and fatigue. The aims of the present study were 1) to describe immediate postoperative physiotherapeutic interventions in two MG patients who underwent thymectomy, and 2) to discuss postoperative rehabilitative issues in MG patients. MATERIALS AND METHODS: This was a non-experimental study analyzing two subjects with MG who underwent thymectomy...
2017: Annali Italiani di Chirurgia
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
#5
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/28417610/functional-outcome-of-critical-illness-polyneuropathy-in-patients-affected-by-severe-brain-injury
#6
Domenico Intiso, Filomena DI Rienzo, Andrea Fontana, Maurizio Tolfa, Michelangelo Bartolo, Massimiliano Copetti
BACKGROUND: Critical illness polyneuropathy and myopathy (CIPNM) frequently occur in intensive care unit (ICU) critically ill subjects; about 55-70% of subjects achieve full recovery. CIPNM can occur in ICU subjects with severe acquired brain injury (sABI), but no data have been reported regarding their outcome. AIM: The aim of the present study was to investigate the functional recovery in subjects suffering from both CIPNM and sABI and whether they had poorer outcome than those with sABI only...
April 14, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28388378/protein-turnover-and-metabolism-in-the-elderly-intensive-care-unit-patient
#7
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/28381585/mastering-the-design-for-rehabilitation-strategies-in-icu-survivors
#8
EDITORIAL
Peter E Morris, Ashley Montgomery-Yates
No abstract text is available yet for this article.
April 5, 2017: Thorax
https://www.readbyqxmd.com/read/28379571/safety-and-feasibility-of-a-protocolized-approach-to-in-bed-cycling-exercise-in-the-intensive-care-unit-quality-improvement-project
#9
Ibtehal Kimawi, Bryanna Lamberjack, Archana Nelliot, Amy Lee Toonstra, Jennifer Zanni, Minxuan Huang, Earl Mantheiy, Michelle E Kho, Dale M Needham
Background: : In-bed, supine cycle ergometry as a part of early rehabilitation in the intensive care unit (ICU) appears to be safe, feasible, and beneficial, but no standardized protocol exists. A standardized protocol may help guide use of cycle ergometry in the ICU. Objective: We investigated whether a standardized protocol for in-bed cycling is safe and feasible, and results in cycling for a longer duration and achieves a higher resistance. Design: A quality improvement (QI) project was conducted...
March 31, 2017: Physical Therapy
https://www.readbyqxmd.com/read/28364678/effect-of-neuromuscular-stimulation-and-individualized-rehabilitation-on-muscle-strength-in-intensive-care-unit-survivors-a-randomized-trial
#10
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/28328648/the-economic-and-clinical-impact-of-sustained-use-of-a-progressive-mobility-program-in-a-neuro-icu
#11
Jeannette M Hester, Peggy R Guin, Gale D Danek, Jaime R Thomas, William L Titsworth, Richard K Reed, Terrie Vasilopoulos, Brenda G Fahy
OBJECTIVE: To investigate a progressive mobility program in a neurocritical care population with the hypothesis that the benefits and outcomes of the program (e.g., decreased length of stay) would have a significant positive economic impact. DESIGN: Retrospective analysis of economic and clinical outcome data before, immediately following, and 2 years after implementation of the Progressive Upright Mobility Protocol Plus program (UF Health Shands Hospital, Gainesville, FL) involving a series of planned movements in a sequential manner with an additional six levels of rehabilitation in the neuro-ICU at UF Health Shands Hospital...
June 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
#12
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
#13
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/28297684/physical-and-occupational-therapy-utilization-in-a-pediatric-intensive-care-unit
#14
Liang R Cui, Megan LaPorte, Matthew Civitello, Meg Stanger, Maxine Orringer, Frank Casey, Bradley A Kuch, Sue R Beers, Cynthia A Valenta, Patrick M Kochanek, Amy J Houtrow, Ericka L Fink
PURPOSE: To characterize the use of physical therapy (PT) and occupational therapy (OT) consultation in our pediatric intensive care unit (PICU). MATERIALS AND METHODS: We studied children aged 1week-18years admitted to a tertiary care PICU for ≥3days. Patient characteristics, details of PT and OT sessions and adverse events were collected. A multivariable logistic regression was performed to determine factors associated with receipt of PT and OT consultation with propensity analysis followed by a regression for factors associated with outcome...
March 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28279659/intensive-early-rehabilitation-in-the-intensive-care-unit-for-liver-transplant-recipients-a-randomised-controlled-trial
#15
Pierre Maffei, Sandrine Wiramus, Laurent Bensoussan, Laurence Bienvenu, Eric Haddad, Sophie Morange, Mohamed Fathallah, Jean Hardwigsen, Jean-Michel Viton, Y Patrice Le Treut, Jacques Albanese, Emilie Gregoire
OBJECTIVE: To validate the feasibility and tolerance of an intensive rehabilitation protocol initiated during the postoperative period in Intensive Care Unit (ICU) in liver transplant recipients. DESIGN: Prospective randomized study SETTING: Intensive Care Unit Post Liver Transplantation PARTICIPANTS: and Interventions: This study compared two groups of liver transplant recipients over a period of one year: the control group (n=20) benefited from the usual treatment applied in the ICU (based on physician prescription for the physiotherapist and applied once a day), while the experimental group (n=20) followed a protocol of early and intensive rehabilitation (based on a written protocol validated by physicians and an evaluation by physiotherapist, with two sessions a day)...
March 6, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28255956/sound-level-intensity-severely-disrupts-sleep-in-ventilated-icu-patients-throughout-a-24-h-period-a-preliminary-24-h-study-of-sleep-stages-and-associated-sound-levels
#16
Maxime Elbaz, Damien Léger, Fabien Sauvet, Benoit Champigneulle, Stéphane Rio, Mélanie Strauss, Mounir Chennaoui, Christian Guilleminault, Jean Paul Mira
BACKGROUND: It is well recognized that sleep is severely disturbed in patients in intensive care units (ICU) and that this can compromise their rehabilitation potential. However, it is still difficult to objectively assess sleep quantity and quality and the determinants of sleep disturbance remain unclear. The aim of this study was therefore to evaluate carefully the impact of ICU sound intensity levels and their sources on ICU patients' sleep over a 24-h period. METHODS: Sleep and sound levels were recorded in 11 ICU intubated patients who met the criteria...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28231030/safety-of-patient-mobilization-and-rehabilitation-in-the-intensive-care-unit-systematic-review-with-meta-analysis
#17
Peter Nydahl, Thiti Sricharoenchai, Saurabh Chandra, Firuzan Sari Kundt, Minxuan Huang, Magdalena Fischill, Dale M Needham
BACKGROUND: Early mobilization and rehabilitation of patients in intensive care units (ICUs) may improve physical function, and reduce the duration of delirium, mechanical ventilation, and ICU length of stay. However, safety concerns are an important barrier to widespread implementation. OBJECTIVES: To synthesize safety data regarding patient mobilization and rehabilitation in the ICU, including falls, removal of endotracheal tubes, removal or dysfunction of intravascular catheters, removal of other catheters/tubes, cardiac arrest, hemodynamic changes, and desaturation...
May 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28230563/implementation-of-an-early-mobility-pathway-in-neurointensive-care-unit-patients-with-external-ventricular-devices
#18
Megan Moyer, Bethany Young, Eileen Maloney Wilensky, Joseph Borst, William Pino, Marisa Hart, Jesse LoBreglio, Derek Zaleski, Isaira Leonor, David Kung, Michelle Smith, Eric Zager, M Sean Grady, Monisha Kumar
BACKGROUND: Patients with an external ventricular drain (EVD) may not be readily mobilized because of concerns of catheter dislodgment and/or inappropriate cerebrospinal fluid drainage. Delayed mobilization may result in longer hospital stays and an increased risk for complications related to immobility. We aimed to determine the safety, feasibility, and outcome of an EVD mobilization protocol in patients with subarachnoid hemorrhage (SAH). METHODS: A multidisciplinary group developed a formal algorithm for the mobilization of patients with SAH with EVDs...
April 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
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
#19
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...
April 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28120079/correlation-between-timing-of-surgery-and-outcome-in-thoracolumbar-fractures-does-early-surgery-influence-neurological-recovery-and-functional-restoration-a-multivariate-analysis-of-results-in-our-experience
#20
Alessandro Landi, Nicola Marotta, Angela Ambrosone, Emiliano Prizio, Cristina Mancarella, Fabrizio Gregori, Giuseppe La Torre, Antonio Santoro, Roberto Delfini
BACKGROUND: Treatment for spinal trauma is affected by both nonmodifiable and modifiable variables. The aim of this study was to compare early surgery with intermediate and late surgery to determine the benefits of spinal reconstruction in neurological recovery and functional restoration in patients with thoracolumbar fractures. METHODS: In order to identify correlations between treatment timing, fracture site, neurological recovery, American Spinal Injury Association (ASIA) score restoration, and rehabilitation prognosis in patients with thoracic and lumbar fractures, we conducted a multivariate analysis of the results of surgery, at our institution, in 166 consecutive patients with unstable thoracolumbar fractures with or without neurological impairment...
2017: Acta Neurochirurgica. Supplement
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