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Titre : | Exercise interventions are delayed in critically ill patients: a cohort study in an Australian tertiary intensive care unit (2020) |
Auteurs : | Marc R. Nickels ; Leanne M. Aitken ; James Walsham ; Lisa J. Crampton ; Adrian G. Barnett ; Steven M. McPhail |
Type de document : | Article |
Dans : | Physiotherapy (Vol. 109, 2020) |
Article en page(s) : | p. 75-84 |
Note générale : | https://doi.org/10.1016/j.physio.2019.06.011 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Études de cohortes ; Kinésithérapie (spécialité) ; Lever précoce ; Maladie grave ; Réadaptation ; Unités de soins intensifs |
Résumé : |
Objectives
This study aims to (i) describe the time to exercise commencement (sitting and upright activities) relative to ICU admission and relative to achievement of initial neurological, respiratory and cardiovascular stability; (ii) examine factors associated with whether sitting and upright activities occurred in ICU; and (iii) examine factors associated with time taken to commence these activities after stability has been achieved. Design Five-year historical cohort study. Setting An Australian tertiary mixed medical, surgical, trauma ICU. Participants The cohort (n = 3222, mean (SD) age 54 (18) years, 67% male) included consecutive ICU patients with length of stay over 48 hours admitted to a tertiary ICU who achieved stability. Main outcome measures Time from stability to patients first completed sitting and upright activities was calculated. Logistic regression (and Cox proportional hazard models) examined whether sitting and upright activities in ICU occurred (and time to these events). Interventions None. Results For patients who completed exercise interventions (n = 1845/3222, 57%), this commenced a median (IQR) 2.3 (1.34.4) days after stability for upright activities and 2.7 (1.55.7) days for sitting. A large proportion of patients did not complete exercise interventions despite achieving stability (n = 1377/3222, 43%). Elective surgical admissions, lower illness severity and older age were associated with completion (and earlier completion) of sitting and upright activity (P Conclusions Many stable patients did not commence sitting or upright activity in ICU despite known benefits, or commencement was somewhat delayed. Opportunities may exist to improve patient outcomes through timely implementation of exercise-based interventions. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0031940618302517#! |