| Titre : | An Early Tailored Approach Is the Key to Effective Rehabilitation in the Intensive Care Unit (2019) |
| Auteurs : | Alice Chiarici ; Elisa Andrenelli ; Oletta Serpilli |
| Type de document : | Article |
| Dans : | Archives of Physical Medicine and Rehabilitation (Vol. 100, n° 8, 2019) |
| Article en page(s) : | p. 1506-1514 |
| Langues: | Anglais |
| Descripteurs : |
HE Vinci Durée du séjour ; Rééducation et réadaptation ; Respirateurs artificiels ; Unités de soins intensifs |
| Résumé : |
Objective
To investigate the effectiveness, feasibility, and safety of an evidence-based rehabilitation care pathway in the intensive care unit (ICU) in different patient populations. Design Observational prospective cohort study, with retrospective controls. Setting ICUs of a university hospital. Participants Patients admitted between April 1, 2015, and June 30, 2015, were compared to a retrospective cohort admitted to the same ICUs during the same 3-month period in 2014. The number of patients studied (N=285) included 152 in the prospective group and 133 in the retrospective group. Interventions The prospective cohort benefited of a rehabilitation care pathway based on (1) interdisciplinary teamwork; (2) early customized and goal-oriented rehabilitation; (3) daily functional monitoring and treatment revision; (4) agreed discharge policy; and (5) continuity of care. The retrospective cohort underwent usual care. Main Outcome Measures Included the following: (1) proportions of patients undergoing rehabilitation team evaluation; (2) latency between patient admission to ICUs and rehabilitation team assessment; (3) proportions of patients undergoing rehabilitation treatment during ICU stay; (4) latency between the patient admission to ICUs and rehabilitation start; (5) ICU stay and total acute hospital stay; and (5) proportion of ventilator-free days out of ICU stay. Results The novel rehabilitation care pathway led to (1) an increased proportion of patients receiving rehabilitative assessment (P<.0001 a decreased latency from icu admission to both rehabilitation team assessment and start an increased proportion of patients undergoing shorter length stay in icus hospital mechanical ventilation duration direct relationship between was observed.> Conclusions An early, interdisciplinary team approach, providing a customized dynamic planning of physiotherapy programs, increases ventilator-free time and reduces total hospital stay, especially in patients admitted to the ICU after general surgery. This rehabilitation care pathway can be generalized to different geopolitical scenarios, being feasible, safe and cost effective. |
| Disponible en ligne : | Oui |
| En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999319301066 |
Bibliothèques HE Vinci
