Safety of Patient Mobilization and Rehabilitation in the Intensive Care Unit. Systematic Review with Meta-Analysis

Nydahl, Peter; Sricharoenchai, Thiti; Chandra, Satya V.; Kundt, Firuzan Sari; Huang, Minxuan; Fischill, Magdalena; Needham, Dale M.

doi:10.1513/annalsats.201611-843sr

Cited by 314 publications

(250 citation statements)

References 73 publications

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“…Early and progressive mobilization has been demonstrated to be both safe and feasible for patients admitted to critical care. 25 Implementing early mobility programs has led to improvements in physical function and mobility levels, significant reductions in both ICU and hospital LOS, and ventilation days and a reduction in both the incidence and duration of delirium. 26 In fact, the ABCDE bundle is centered on approaches to implement the Integrated pain, agitation, and delirium clinical practice guidelines to reduce delirium and weakness related to oversedation, prolonged mechanical ventilation, and immobility in mechanically ventilated critically ill patients.…”

Section: Discussionmentioning

confidence: 99%

Implementing the comprehensive unit-based safety program model to improve the management of mechanically ventilated patients in Saudi Arabia

Khan

Aljuaid

Almutairi

et al. 2019

American Journal of Infection Control

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Section: Discussionmentioning

confidence: 99%

Implementing the comprehensive unit-based safety program model to improve the management of mechanically ventilated patients in Saudi Arabia

Khan

Aljuaid

Almutairi

et al. 2019

American Journal of Infection Control

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“…21 Two mechanisms of action are proposed for the therapeutic effects of TEMS, the overload principle and the selective recruitment of type II fibers. 8 TES is proposed as an alternative method to increase the local blood flow of the targeted muscles.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 Multimodal, interdisciplinary approaches to mobility-based physical therapy have shown to reduce the incidence of pulmonary complications, functional decline, length of mechanical ventilation, and hospital stay in critically ill adults. 8,9 Although there is a paucity of pediatric evidence on the efficacy of early mobilization in the PICU, 10 the results of a systematic review about early mobilization in critically ill children demonstrated that neurodevelopmentally appropriate increasing mobility levels have been defined, mobilitybased physical rehabilitation is safe and feasible, and the efficacy for early mobilization in this population is as yet undetermined because of the low certainty in the currently available evidence. 11 In contrast, some patients are not able to perform voluntary muscular contraction, which prevents their active participation in the rehabilitation process.…”

Section: Introductionmentioning

confidence: 99%

Is transcutaneous electrical muscle stimulation an alternative for preventing acquired muscle weakness in the pediatric intensive care unit? A scoping review

Magalhães

Figueirêdo

Vasconcelos

et al. 2019

Pediatric Pulmonology

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Background Transcutaneous electrical muscle stimulation (TEMS) has been progressively used as add‐on therapy to reduce muscle atrophy in adults unable to carry out active mobilization in the intensive care unit (ICU). There are no studies addressing TEMS in the pediatric ICU. Therefore, we decided to develop a scoping review, a type of knowledge synthesis, which unlike systematic review, identify gaps in the literature to aid the planning and commissioning of future research. Objective To provide current perspectives on the application of TEMS for combating pediatric intensive care unit acquired weakness (PICUAW). Methods Online databases were used to identify papers published 2006–2016, from which we selected those used musculoskeletal and cardiorespiratory performance as a primary or secondary outcome variable in participants under 18 years. Results The publications reported six clinical trials from 218 outpatients with 9.5 ± 8 years old. There were differences in current modulation and duration of TEMS sessions, with a predominance of high intensity and short duration in which a muscle contraction is triggered. The main use of TEMS was in pediatric neurological disorders. TEMS was more effective when compared with SHAM on spasticity, bone mineral density, disability, and gait. One study regarding spine injury showed improvement in VO2 (P = 0.035) when combined cycling with TEMS. Conclusion TEMS was an effective and safe treatment for musculoskeletal impairments and cardiorespiratory performance in children with neurological disorders. Although the physiopathology is different in outpatients, an individualized protocol with TEMS might be promising for preventing PICUAW. Its eﬀectiveness, however, deserves further investigation.

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“…It was shown that early mobilization and physical rehabilitation of critically ill patients seemed to be safe, with a low risk of potential safety events, even if as a usual care. Although the definition of safety assessments was heterogeneous, it was emphasized that the awareness and implementation of existing recommendations should be increased [112].…”

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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Safety of Patient Mobilization and Rehabilitation in the Intensive Care Unit. Systematic Review with Meta-Analysis

Cited by 314 publications

References 73 publications

Implementing the comprehensive unit-based safety program model to improve the management of mechanically ventilated patients in Saudi Arabia

Implementing the comprehensive unit-based safety program model to improve the management of mechanically ventilated patients in Saudi Arabia

Is transcutaneous electrical muscle stimulation an alternative for preventing acquired muscle weakness in the pediatric intensive care unit? A scoping review

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

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