Rehabilitation during mechanical ventilation: Review of the recent literature

Ntoumenopoulos, George

doi:10.1016/j.iccn.2015.02.001

Cited by 32 publications

(37 citation statements)

References 62 publications

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“…These musculoskeletal changes also involve the vascular system (with decrease of venous return) and the respiratory system (due to respiratory muscle weakness), thus hindering the withdrawal of the MV 3,8 . Much has been discussed about the impact of neuromuscular dysfunction in critical patients admitted to an ICU.…”

Section: Discussionmentioning

confidence: 99%

Existe diferença na mobilização precoce entre os pacientes clínicos e cirúrgicos ventilados mecanicamente em UTI?

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Existe diferença na mobilização precoce entre os pacientes clínicos e cirúrgicos ventilados mecanicamente em UTI?

et al. 2016

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“…This neuromuscular weakness has been found to be correlated with the duration of mechanical ventilation, and associated with functional disability and decreased quality of life for up to 5 years after hospitalization. Mobilization and rehabilitation of critically ill patients might improve physical functioning and decrease duration of mechanical ventilation and ICU length of stay [110,111]. A metaanalysis was published in 2017 that consisted of studies with PR programs containing patient mobilization, walking, standing, breathing exercises, in-bed supine cycle ergometry, passiveactive range of motion (ROM), and NMES.…”

Section: Pr In the Intensive Unit Carementioning

confidence: 99%

Advances in Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease and Associated Conditions

Candemir¹

2018

COPD - An Update in Pathogenesis and Clinical Management

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Pulmonary rehabilitation (PR) is an evidenced-based, proven treatment as mentioned recent guidelines in patients with chronic obstructive pulmonary disease (COPD). Exercise training is a cornerstone of PR programs, Inspiratory muscle training, neuromuscular electrical stimulation (NMES) are effective in selected patients. Water-based rehabilitation and tai chi are well tolerated recent modalities. Although there is an absence of a specific PR protocol for special conditions, PR is recommended before and also after endobronchial volume reduction (EBVR), lung volume reduction surgery (LVRS), both before and after lung transplantation periods, before, after surgery, during the intensive care unit (ICU) period, the chemotherapy period and as a component of palliative care. After COPD exacerbation, it is recommended within 3 weeks of hospital discharge. Modifying PR programs while considering comorbidities might lead to greater improvement in outcomes. After PR, the important points are to follow prescribed home exercise programs, control programs in the PR center/unit, and being more active in daily living life for the purpose of preserving improvements. Tele-PR is an alternative to conventional modalities due to similar improvements. Although PR is effective, it is an underutilized resource. The awareness of PR should be increased in patients and among health professionals.

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“…It is defined as symmetrical weakness in upper and lower limbs and is diagnosed with a medical research council (MRC) score sum less than 48[2]. Prolonged bed rest, systemic inflammation, hyperglycaemia, sedation, sepsis, malnutrition, patient immobilization, use of corticosteroids and neuromuscular blockers, among others, are considered risk factors for ICU-AW and, consequently, poorer functional outcome[3,4]. …”

Section: Introductionmentioning

confidence: 99%

Determination of functional prognosis in hospitalized patients following an intensive care admission

Ferreira¹,

Lopes²,

Ferreira³

et al. 2016

WJCCM

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AIMTo investigate the factors associated with the functional progress of hospitalized patients following an intensive care admission.METHODSRetrospective study including data from a cohort of 198 hospitalized patients following an intensive care admission and not requiring mechanical ventilation in a single tertiary referral hospital. A generalized linear model was used to identify the main effects of clinical and demographic variables on the outcomes of functionality (KATZ Index of Independence in Activities of Daily Living) and muscle strength (MRC Scale). The covariates identified as independent predictors were analysed using the receiver operating characteristic curves. The analysis differentiated the periods in the intensive care unit (ICU), in the Ward (WARD) and the total time of hospital stay (TOT).RESULTSConsidering the functional outcome (ΔKATZ), the variables that significantly contributed to the model (P < 0.05) were the KATZ and MRC on admission, age, sepsis (no), and total length of stay (TLS). Regarding the muscle strength outcome model (ΔMRC), the predictors were MRC on admission, Simplified Acute Physiology Score III, previous stroke, TLS, and sex (female). The variable age (AUC = 0.664) discriminated the ΔKATZICU. The variables age (AUC = 0.712), KATZ in ICU (AUC = 0.590) and on ward admission (AUC = 0.746), and MRC on ward admission (AUC = 0.721) were discriminative for ΔKATZWARD. For ΔKATZTOT the variables KATZ on ICU admission (AUC = 0.621) and TLS (AUC = 0.617) were discriminative. For ΔMRCICU the variables SAPSIII (AUC = 0.661) and MRC on ICU admission (AUC = 0.653) were discriminative. MRC on ICU (AUC = 0.681) and ward admission (AUC = 0.553) were discriminative for ΔMRCWARD. TLS (AUC = 0.649) and MRC on ward admission (AUC = 0.696) discriminative for the ΔMRCTOT.CONCLUSIONSpecific functional, clinical and demographical variables at ICU admission are associated with the functional prognosis during the hospitalization period.

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Rehabilitation during mechanical ventilation: Review of the recent literature

Cited by 32 publications

References 62 publications

Existe diferença na mobilização precoce entre os pacientes clínicos e cirúrgicos ventilados mecanicamente em UTI?

Existe diferença na mobilização precoce entre os pacientes clínicos e cirúrgicos ventilados mecanicamente em UTI?

Advances in Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease and Associated Conditions

Determination of functional prognosis in hospitalized patients following an intensive care admission

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