Functional ability and quality of life in critical illness survivors with intensive care unit acquired weakness: A secondary analysis of a randomised controlled trial

Eggmann, Sabrina; Luder, Gere; Verra, Martin L.; Irincheeva, Irina; Bastiaenen, Caroline; Jakob, Stephan M.

doi:10.1371/journal.pone.0229725

Cited by 53 publications

(32 citation statements)

References 46 publications

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“…On 31 December 2019, 27 cases of coronavirus disease 2019 (COVID-19) with pneumonia of unknown etiology were first reported in Wuhan city, Hubei, China [ 1 ]. Thereafter, there was a COVID-19 outbreak worldwide and the World Health Organization declared the outbreak a public health emergency of international concern on 30 January 2020 [ 2 ] and a pandemic crisis on 11 March 2020 [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Statin Therapy and the Risk of COVID-19: A Cohort Study of the National Health Insurance Service in South Korea

Song

Jeon

2021

JPM

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We aimed to investigate whether statin therapy is associated with the incidence of coronavirus disease 2019 (COVID-19) among the South Korean population. In addition, we examined whether statin therapy affects hospital mortality among COVID-19 patients. The National Health Insurance Service (NHIS)-COVID-19 database in South Korea was used for data extraction for this population-based cohort study. A total of 122,040 adult individuals, with 22,633 (18.5%) in the statin therapy group and 101,697 (91.5%) in the control group, were included in the analysis. Among them, 7780 (6.4%) individuals were diagnosed with COVID-19 and hospital mortality occurred in 251 (3.2%) COVID-19 cases. After propensity score matching, logistic regression analysis showed that the odds of developing COVID-19 were 35% lower in the statin therapy group than in the control group (odds ratio: 0.65, 95% confidence interval: 0.60 to 0.71; p < 0.001). Regarding hospital mortality among COVID-19 patients, the multivariable model indicated that there were no differences between the statin therapy and control groups (odds ratio: 0.74, 95% confidence interval: 0.52 to 1.05; p = 0.094). Statin therapy may have potential benefits for the prevention of COVID-19 in South Korea. However, we found that statin therapy does not affect the hospital mortality of patients who are diagnosed with COVID-19.

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Section: Introductionmentioning

confidence: 99%

Statin Therapy and the Risk of COVID-19: A Cohort Study of the National Health Insurance Service in South Korea

Song

Jeon

2021

JPM

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“…A major problem after long-term intensive care treatment is the intensive care unit-acquired weakness syndrome (ICUAWS), which can be triggered by sepsis, multiorgan failure, glucocorticoids, neuromuscular blocking agents, hyperglycemia and immobility itself [ 1 ]. Reported incidence rates of ICUAWS range from 25 to 100% and may independently contribute to the one year mortality rate [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

The Feasibility of High-Intensity Interval Training in Patients with Intensive Care Unit-Acquired Weakness Syndrome Following Long-Term Invasive Ventilation

Wernhart

Hedderich²,

Wunderlich

et al. 2021

Sports Med - Open

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Background Intensive care unit-acquired weakness syndrome (ICUAWS) can be a consequence of long-term mechanical ventilation. Despite recommendations of early patient mobilisation, little is known about the feasibility, safety and benefit of interval training in early rehabilitation facilities (ERF) after long-term invasive ventilation. Methods and Results We retrospectively analysed two established training protocols of bicycle ergometry in ERF patients after long-term (> 7 days) invasive ventilation (n = 46). Patients conducted moderate continuous (MCT, n = 24, mean age 70.3 ± 10.1 years) or high-intensity interval training (HIIT, n = 22, mean age 63.6 ± 12.6 years). The intensity of training was monitored with the BORG CR10 scale (intense phases ≥ 7/10 and moderate phases ≤ 4/10 points). The primary outcome was improvement (∆-values) of six-minute-walk-test (6 MWT), while the secondary outcomes were improvement of vital capacity (VCmax), forced expiratory volume in 1 s (FEV1), maximal inspiratory pressure (PImax) and functional capabilities (functional independence assessment measure, FIM/FAM and Barthel scores) after 3 weeks of training. No adverse events were observed. There was a trend towards a greater improvement of 6 MWT in HIIT than MCT (159.5 ± 64.9 m vs. 120.4 ± 60.4 m; p = .057), despite more days of invasive ventilation (39.6 ± 16.8 days vs. 26.8 ± 16.2 days; p = .009). VCmax (∆0.5l ± 0.6 vs. ∆0.5l ± 0.3; p = .462), FEV1 (∆0.2l ± 0.3 vs. ∆0.3l ± 0.2; p = .218) PImax (∆0.8 ± 1.1 kPa vs. ∆0.7 ± 1.3pts; p = .918) and functional status (FIM/FAM: ∆29.0 ± 14.8pts vs. ∆30.9 ± 16.0pts; p = .707; Barthel: ∆28.9 ± 16.0 pts vs. ∆25.0 ± 10.5pts; p = .341) improved in HIIT and MCT. Conclusions We demonstrate the feasibility and safety of HIIT in the early rehabilitation of ICUAWS patients. Larger trials are necessary to find adequate dosage of HIIT in ICUAWS patients.

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“…Critical illness with prolonged mechanical ventilation is associated with loss of muscle mass accompanied by profound, generalised muscle weakness that has been termed intensive care unit acquired weakness (ICU-AW) [1][2][3][4]. Recovery is often prolonged and incomplete [5,6], but seems to be facilitated by early rehabilitation starting in the ICU [7,8]. However, to properly assess, treat, and evaluate the physical function and activity of critically ill patients a practical, valid, and reliable assessment tool is needed [9].…”

Section: Introductionmentioning

confidence: 99%

German version of the Chelsea Critical Care Physical Assessment Tool (CPAx-GE): translation, cross-cultural adaptation, validity, and reliability

Eggmann

Verra

Stefanicki

et al. 2021

Disability and Rehabilitation

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Purpose: To translate and cross-culturally adapt the Chelsea Critical Care Physical Assessment tool from English to German (CPAx-GE) and to examine its validity and reliability. Materials and methods: Following a forward-backward translation including an expert round table discussion, the measurement properties of the CPAx-GE were explored in critically ill, mechanically ventilated adults. We investigated construct, cross-sectional, and cross-cultural validity of the CPAx-GE with other measurement instruments at pre-specified timepoints, analysed relative reliability with intraclass correlation coefficients (ICCs) and determined absolute agreement with the Bland-Altman plots. Results: Consensus for the translated CPAx-GE was reached. Validity was excellent with >80% of the prespecified hypotheses accepted at baseline, critical care, and hospital discharge. Interrater reliability was high (ICCs > 0.8) across all visits. Limit of agreement ranged from À2 to 2 points. Error of measurement was small, floor, and ceiling effects limited. Conclusions: The CPAx-GE demonstrated excellent construct, cross-sectional, and cross-cultural validity as well as high interrater reliability in critically ill adults with prolonged mechanical ventilation at baseline, critical care, and hospital discharge. Consequently, the CPAx-GE can be assumed equal to the original and recommended in the German-speaking area to assess physical function and activity of critically ill adults across the critical care and hospital stay. Trial registration: German Clinical Trials Register (DRKS) identification number: DRKS00012983 (https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00012983), registered on 20 September 2017, first patient enrolled on 21 November 2017. ä IMPLICATIONS FOR REHABILITATIONEarly rehabilitation of critically ill patients is recommended to prevent and treat the subsequent functional disability, but a suitable measurement instrument for the German-speaking area is lacking. The translated, cross-culturally adapted German CPAx demonstrated excellent validity and reliability in assessing physical function and activity in critically ill adults. Cross-sectional validity of the CPAx has been newly established and allows the use of this tool at clinically relevant time-points in the course of a critical illness. The CPAx-GE can therefore be used in clinical practice by German-speaking therapists to assess physical function and activity during early rehabilitation in the ICU and hospital.

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Functional ability and quality of life in critical illness survivors with intensive care unit acquired weakness: A secondary analysis of a randomised controlled trial

Cited by 53 publications

References 46 publications

Statin Therapy and the Risk of COVID-19: A Cohort Study of the National Health Insurance Service in South Korea

Statin Therapy and the Risk of COVID-19: A Cohort Study of the National Health Insurance Service in South Korea

The Feasibility of High-Intensity Interval Training in Patients with Intensive Care Unit-Acquired Weakness Syndrome Following Long-Term Invasive Ventilation

German version of the Chelsea Critical Care Physical Assessment Tool (CPAx-GE): translation, cross-cultural adaptation, validity, and reliability

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