Multidisciplinary rehabilitation in ventilator-dependent patients: Call for action in specialized inpatient facilities

Camacho, Rosa; Ambrosino, Nicolino

doi:10.1016/j.rppnen.2015.03.005

Cited by 6 publications

(4 citation statements)

References 48 publications

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“…Dentro de los procedimientos del fonoaudiólogo en sala de urgencias, se mencionan la detección, evaluación e intervención en alteraciones deglutorias, que permita direccionar hacia una hospitalización, exámenes dinámicos de la función deglutoria, o estrategias de acompañamiento a cuidadores y familiares para un egreso seguro (Cassarino, y otros, 2019); (Jeyaseelan, Vargo, & Chae, 2015); (Lynch, Luker, Cadilhac, & Hil, 2015); (Sung, Lee, Choi, & Kim, 2018). Dada la necesidad inmediata para tomar decisiones clínicas conjuntas, se orientan estrategias hacia el cuidado de la cavidad oral, maniobras deglutorias y técnicas de alimentación segura, con cambios posturales y modificación de consistencias en los alimentos (Bahcecı, Umay, Gundogdu, Gurcay, Ozturk, & Alıcura, 2017); (Carmignani, y otros, 2018); (Winck, Camacho, & Ambrosino, 2015). Así, la presencia del fonoaudiólogo permite una evaluación clínica precisa para la identificación rápida de signos y riesgo de disfagia, y un plan de rehabilitación inmediato para la deglución por medio de estrategias específicas, en acuerdo con otros profesionales (Almeida, Mahmud, & Finard, 2018); (Bahcecı, Umay, Gundogdu, Gurcay, Ozturk, & Alıcura, 2017); (Lal, Wishart, Ward, Schwarz, Seabrook, & Coccetti, 2020).…”

Section: Tabla 1 Resultados De Búsqueda De Literaturaunclassified

Fonoaudiología En Salas De Urgencias: Perspectiva Desde Una Revisión Documental

et al. 2021

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Las salas de urgencias son espacios con protocolos coordinados y actuaciones diagnósticas y terapéuticas secuenciales. Los profesionales de rehabilitación en urgencias aportan a la toma de decisiones sobre conductas de hospitalización o egreso, planes caseros, ayudas diagnósticas y remisión a especialistas. El propósito de este análisis de literatura fue identificar evidencia internacional, sobre el fonoaudiólogo en sala de urgencias y sus acciones profesionales con pacientes, familiares y equipos de salud. Materiales y métodos. Se revisó evidencia de las bases de datos Ebsco, PubMed, Scielo, Elsevier y Web of Science, entre enero de 2015 hasta septiembre de 2020, con términos de búsqueda: speech language pathology, speech therapy, emergency room en español e inglés. Se seleccionaron documentos que informaran sobre procesos de rehabilitación en salas de urgencias, que incluyeran acciones desde fonoaudiología. Se analizaron 51 documentos según criterios de inclusión. La evidencia muestra la incursión del trabajo fonoaudiológico en un contexto no tradicional, motivado por las necesidades en la toma de decisiones clínicas en diálogo interdisciplinar, principalmente en condiciones de disfagia y alteraciones deglutorias. Las acciones profesionales en este contexto incluyen la promoción y prevención de ingresos a sala de urgencias, hasta la atención en condiciones críticas, agudas y al final de la vida. Este contexto representa retos profesionales hacia habilidades de juicio clínico, argumentación científico profesional, uso de instrumentos de detección y trabajo interdisciplinar. que hacen la diferencia entre aspectos como el egreso y la hospitalización, un tratamiento o procedimiento y en algunos casos, entre la vida y la muerte.

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Section: Tabla 1 Resultados De Búsqueda De Literaturaunclassified

Fonoaudiología En Salas De Urgencias: Perspectiva Desde Una Revisión Documental

et al. 2021

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“…Moreover, it has been shown that cough peak flow predicts pulmonary complications in dysphagic patients [38] and correlates significantly with the CPAx score [13]. In addition, insufficient cough strength has a major role in failed extubation/decannulation in patients with high level spinal cord injury, primary neuromuscular disorders or ICU-acquired weakness [4].…”

Section: Discussionmentioning

confidence: 99%

“…Beyond prolonged dependence on mechanical ventilation, muscle, neuro-endocrine, skin and brain dysfunctions accumulate into a distinct and complex syndrome impacting not only families of the chronically critically ill patient but also the whole health care system [3]. Evaluating the health status of these patients is of major importance to adopt the best appropriate care management and better define prognosis by better understanding their general health, and to evaluate results of multidisciplinary rehabilitation [4].…”

Section: Introductionmentioning

confidence: 99%

Validation of the Multi-INdependence Dimensions (MIND) questionnaire for prolonged mechanically ventilated subjects

Gilet

Kalin

Murcia³

et al. 2019

BMC Pulm Med

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Background Evaluating severity of illness of patients with prolonged mechanical ventilation (PMV) is important to adopt the best appropriate care management for each individual. Yet, no severity-of-illness scoring system has been specifically designed for this type of patients. The aim of this study was to develop and validate a new instrument, the Multi-INdependence Dimensions (MIND) questionnaire designed to comprehensively measure the severity of illness of patients under PMV. Methods The validation of the MIND questionnaire was performed during a longitudinal observational study conducted with PMV subjects in weaning facilities in three countries (Argentina, Colombia and Germany). The questionnaire validity was tested in 3 stages: 1) Specification of components, with description of item responses, inter-item and Cronbach alpha correlations; 2) Creation of the composite scores; 3) Measurement properties determination including test-retest reliability after 30 days, clinical validity (Medical Research Council (MRC) muscle strength score, Sepsis-related Organ Failure Assessment (SOFA), Glasgow Coma Scale (GCS), Dependence Nursing Scale and EuroQol-5 Dimension evaluated at inclusion), and ability to detect change. Results A total of 128 subjects participated in the validation study. Eleven component scores and four composite scores were created. MIND scores significantly correlated with MRC muscle strength, SOFA, DNS, GCS and EQ-5D, supporting the validity of the new scores. Intraclass Correlation Coefficient greater than 0.82 were observed for all composite scores, indicating good test-retest reliability. MIND scores were able to detect improvement in subject severity of illness. Conclusion The MIND questionnaire is a valid and reliable instrument for measuring comprehensively the multiple dimensions characterizing the severity of illness of PMV patients. Trial registration NCT02255058 . Electronic supplementary material The online version of this article (10.1186/s12890-019-0870-2) contains supplementary material, which is available to authorized users.

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“…Besides medical care, skilled nursing, dedicated respiratory therapy, physiotherapy, speech and language pathology, occupational therapy, psychological care, wound care, nutritional support, care coordination and family support all contribute to the success of weaning in prolonged MV patients. While discussing the role of all these factors is beyond the scope of this review, we would like to acknowledge that a collaborative patient and center-specific approach is necessary for the successful rehabilitation of patients with a prolonged ventilation need [81].…”

Section: The Role Of Complex Rehabilitationmentioning

confidence: 99%

Ventilator Weaning in Prolonged Mechanical Ventilation—A Narrative Review

Dolinay,

Hsu,

Maller

et al. 2024

JCM

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Patients requiring mechanical ventilation (MV) beyond 21 days, usually referred to as prolonged MV, represent a unique group with significant medical needs and a generally poor prognosis. Research suggests that approximately 10% of all MV patients will need prolonged ventilatory care, and that number will continue to rise. Although we have extensive knowledge of MV in the acute care setting, less is known about care in the post-ICU setting. More than 50% of patients who were deemed unweanable in the ICU will be liberated from MV in the post-acute setting. Prolonged MV also presents a challenge in care for medically complex, elderly, socioeconomically disadvantaged and marginalized individuals, usually at the end of their life. Patients and their families often rely on ventilator weaning facilities and skilled nursing homes for the continuation of care, but home ventilation is becoming more common. The focus of this review is to discuss recent advances in the weaning strategies in prolonged MV, present their outcomes and provide insight into the complexity of care.

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Multidisciplinary rehabilitation in ventilator-dependent patients: Call for action in specialized inpatient facilities

Cited by 6 publications

References 48 publications

Fonoaudiología En Salas De Urgencias: Perspectiva Desde Una Revisión Documental

Fonoaudiología En Salas De Urgencias: Perspectiva Desde Una Revisión Documental

Validation of the Multi-INdependence Dimensions (MIND) questionnaire for prolonged mechanically ventilated subjects

Ventilator Weaning in Prolonged Mechanical Ventilation—A Narrative Review

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