Early Rehabilitation Feasibility in a COVID-19 ICU

Abstract

Survivors of critical illness have long-term morbidity resulting in physical, emotional, and cognitive dysfunction. 1,2 Early mobilization improves functional outcomes and is essential to quality critical care. [3][4][5][6] Early mobilization is feasible and safe for critically ill patients, including those receiving mechanical ventilation and extracorporeal membranous oxygenation (ECMO).

Time to active sitting position: One-year findings from a temporary COVID-19 intensive care unit

“…It is interesting to compare our results with previous findings on people undergoing physiotherapy during ICU stay. On average, ICU LOS and IMV duration were higher in our study compared to other reports [ 5 , 42 ]; Stutz et al enrolled a population of less severe patients with COVID-19, where only 40% of subjects were intubated, as compared to 99.6% of our work. Moreover, we counted less tracheostomy procedures as opposed to McWilliams et al (27.8% versus 77%), investigating a population of severe patients with COVID-19 from United Kingdom.…”

Early Intensive Physical Rehabilitation Combined with a Protocolized Decannulation Process in Tracheostomized Survivors from Severe COVID-19 Pneumonia with Chronic Critical Illness

“…Long-term physical, cognitive and psychosocial consequences have been identified in ICU survivors from the CARDS. Several authors pleaded for the implementation of early rehabilitation in mechanically ventilated patients with CARDS [19][20][21]. Stutz et al demonstrated the feasibility of implementing physical and occupational therapy in a population of critically ill COVID-19 patients [20].…”

“…Several authors pleaded for the implementation of early rehabilitation in mechanically ventilated patients with CARDS [19][20][21]. Stutz et al demonstrated the feasibility of implementing physical and occupational therapy in a population of critically ill COVID-19 patients [20]. In 43 CARDS patients admitted to a post-ICU weaning center, Faure et al found that the MRC on admission was the only factor independently associated with early decannulation [21].…”

Two years of COVID-19: Trends in rehabilitation

“… 13 Several studies of acute inpatient rehabilitation conducted during the first pandemic wave, have demonstrated that an early rehabilitative approach was effective at improving outcomes and facilitating discharge to home. 14 , 15 , 16 , 17 , 18 Nevertheless, the same efficacy was not confirmed when considering mortality; while in some studies rehabilitation was associated with reduced mortality, 19 in others patients had a longer duration of invasive mechanical ventilation, a longer ICU stay, a more extended hospital stay and higher mortality rates. 20 It could be speculated that such differences are probably correlated to pre-existing comorbidities and patient selection.…”

“…From data available in the literature, the rehabilitative treatment provided in acute and subacute hospital settings seems to commence within the first 3-10 days after hospital admission, to be constituted by 15/30-minute sessions having heterogeneous frequencies ranging from twice a week to a daily schedule. 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 …”