Résultat de la recherche
2 résultat(s) recherche sur le mot-clé 'Critical illness'
trié(s) par (Pertinence décroissant(e), Titre croissant(e)) Affiner la recherche Générer le flux rss de la recherche Faire une suggestion
Feasibility of Exercise Testing in Patients Who Are Critically Ill: A Prospective, Observational Multicenter Study / Juultje Sommers in Archives of Physical Medicine and Rehabilitation, Vol. 100, n° 2 (2019)
Titre : Feasibility of Exercise Testing in Patients Who Are Critically Ill: A Prospective, Observational Multicenter Study Type de document : Article Auteurs : Juultje Sommers ; Emily Klooster ; Siebrand B. Zoethout Année de publication : 2019 Article en page(s) : p. 239-246 Langues : Anglais (eng) Descripteurs : HE Vinci
Effort physique ; Epreuve d'effort ; Maladie grave ; Rééducation et réadaptation ; Unités de soins intensifs
Mots-clés : Critical illness Exercise test Intensive Care Units Physical exertion Résumé : Objective
To evaluate the feasibility and safety of exercise testing and to describe the physiological response to exercise of patients in the Intensive Care Unit (ICU).
A prospective observational multicenter study.
Two mixed medical-surgical ICUs.
Patients (N=37; with no primary neurological disorders, 59% men; median age 50y; ICU length of stay 14.5d; Acute Physiology and Chronic Health Evaluation IV 73.0) who had been mechanically ventilated for more than 48 hours and were hemodynamically stable enough to perform physical exercise.
A passive or active incremental exercise test, depending on muscle strength, on a bed-based cycle ergometer.
Main Outcome Measures
Feasibility and safety were evaluated based on protocol adherence and adverse events. Physiological responses to exercise quantified as changes in respiratory frequency (RF), oxygen uptake (Vo2), carbon dioxide output (Vco2), respiratory exchange ratio (RER), and blood lactate.
Thirty-seven patients of whom 18 were mechanically ventilated underwent the exercise test. The active incremental test was performed by 28, and the passive test by 9 participants. Thirty-three (89%) accomplished the test according to the protocol and 1 moderate severe adverse event (bradycardia; heart rate 44) occurred shortly after the test. RF, Vo2, Vco2, and lactate increased significantly, whereas RER did not change during the active incremental exercise test. No changes were observed during the passive exercise test.
It is safe and feasible to perform exercise testing on a bed-based cycle ergometer in patients who are critically ill and a physiological response could be measured. Future research should investigate the clinical value of exercise testing in daily ICU practice and whether exercise capacity and its limiting factors could be determined by incremental exercise testing.
Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink :
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 2 (2019) . - p. 239-246[article]Active Mobilization for Mechanically Ventilated Patients: A Systematic Review / Z. Li in Archives of Physical Medicine and Rehabilitation, 2013/3 (2013)
Titre : Active Mobilization for Mechanically Ventilated Patients: A Systematic Review Type de document : Article Auteurs : Z. Li ; [et al.] Article en page(s) : pp. 551-561 Langues : Anglais (eng) Descripteurs : HE Vinci
Rééducation et réadaptation ; Respiration ; Traitement par les exercices physiques ; Ventilation artificielle
Mots-clés : Critical illness Maladie critique Exercise therapy Artificial Review literature as topic Littérature de revue comme sujet Résumé : "Objective
To investigate the effectiveness and safety of active mobilization on improving physical function and hospital outcomes in patients undergoing mechanical ventilation for more than 24 hours.
PubMed, Embase, CINAHL, CENTRAL, Physiotherapy Evidence Database, SinoMed, and ISI Web of Knowledge were searched for randomized controlled trials (RCTs), quasi-RCTs, other comparative studies, and case series with 10 or more consecutive cases. Additional studies were identified through references, citation tracking, and by contacting the authors of eligible studies.
Two reviewers independently selected potential studies according to the inclusion criteria.
Two reviewers independently extracted data and assessed the methodologic quality.
A narrative form was used to summarize study characteristics and outcomes, because the substantial heterogeneity between the individual studies precluded formal meta-analyses. Among the 17 eligible studies, 7 RCTs, 1 quasi-RCT, 1 prospective cohort study, and 1 history controlled study were used to examine the effectiveness; and 2 RCTs, 1 prospective cohort study, and 7 case series were used to examine the safety of active mobilization in patients receiving mechanical ventilation for more than 24 hours. We found that active mobilization may improve muscle strength, functional independence, and the ability to wean from ventilation and may decrease the length of stay in the intensive care unit (ICU) and hospital. However, only 1 study reported that active mobilization reduced the 1-year mortality rate. No serious adverse events were reported among included studies.
Active mobilization appears to have a positive effect on physical function and hospital outcomes in mechanical ventilation patients. Early active mobilization protocols may be initiated safely in the ICU setting and continued in post-ICU settings. However, the current available studies have great heterogeneity and limited methodologic quality. Further research is needed to provide more robust evidence to support the effectiveness and safety of active mobilization."
Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/journal/a [...] Permalink :
in Archives of Physical Medicine and Rehabilitation > 2013/3 (2013) . - pp. 551-561[article]