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8 résultat(s) recherche sur le mot-clé 'Intensive Care Units' 
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Partager le résultat de cette recherche Faire une suggestionImplementation of a protocol facilitates evidence-based physiotherapy practice in intensive care units / S. Hanekom in Physiotherapy, 2013/2 (2013)
Titre : Implementation of a protocol facilitates evidence-based physiotherapy practice in intensive care units Type de document : Article Auteurs : S. Hanekom ; Q.A. Louw ; A.R. Coetzee Année de publication : 2013 Article en page(s) : pp. 139-145 Langues : Anglais (eng) Descripteurs : HE Vinci
Adhésion aux directives ; Kinésithérapie (spécialité) ; Pratique factuelle (EBP) ; Soins de réanimation ; Unités de soins intensifsMots-clés : Guideline Adherence Physical Therapy Specialty Critical Care Intensive Care Units Résumé : Objectives
To compare the physiotherapy service provided when therapists’ decisions are guided by an evidence-based protocol with usual care (i.e. patient management based on therapists’ clinical decisions).
Design
Exploratory, controlled, pragmatic sequential time block clinical trial.
Setting
Level 3 surgical unit in a tertiary hospital in South Africa.
Participants
All patients admitted consecutively to the surgical unit over a 3-month period were allocated to usual or protocol care based on date of admission.
Interventions
Usual care was provided by clinicians from the hospital department, and non-specialised physiotherapists were appointed as locum tenens to provide evidence-based protocol care.
Main outcome measures
Patient waiting time, frequency of treatment sessions, tasks performed and adverse events.
Results
During protocol-care periods, treatment sessions were provided more frequently (P Conclusions
Physiotherapy services provided in intensive care units (ICUs) when the decisions of non-specialised therapists are guided by an evidence-based protocol are safe, differ from usual care, and reflect international consensus on current best evidence for physiotherapy in ICUs. Non-specialised therapists can use this protocol to provide evidence-based physiotherapy services to their patients. Future trials are needed to establish whether or not this will improve patient outcome.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=134117
in Physiotherapy > 2013/2 (2013) . - pp. 139-145[article]
Titre : What is the role of the physiotherapist in paediatric intensive care units? A systematic review of the evidence for respiratory and rehabilitation interventions for mechanically ventilated patients Type de document : Article Auteurs : Ellie Hawkins ; Anne Jones Année de publication : 2015 Article en page(s) : pp. 303-309 Langues : Anglais (eng) Descripteurs : HE Vinci
Kinésithérapie (spécialité) ; Respirateurs artificiels ; Unités de soins intensifs ; Unités de soins intensifs pédiatriquesMots-clés : Intensive Care Units Pediatric Physical Therapy Specialty Physical therapists Kinésithérapeutes Ventilators Mechanical Résumé : Background
Physiotherapy in intensive care units (ICU) has traditionally focussed on the respiratory management of mechanically ventilated patients. Gradually, focus has shifted to include rehabilitation in adult ICUs, though evidence of a similar shift in the paediatric ICU (PICU) is limited.
Objectives
Review the evidence to determine the role of physiotherapists in the management of mechanically ventilated patients in PICU.
Data sources
A search was conducted of: PEDro, CINAHL, Medline, PubMed and the Cochrane Library.
Eligibility criteria
Studies involving PICU patients who received physiotherapy while invasively ventilated were included in this review. Those involving neonatal or adult ICU patients, or patients on non-invasive or long-term ventilation, were not included in the study.
Study appraisal
All articles were critically appraised by two reviewers and results were analysed descriptively.
Results
Six studies on chest physiotherapy (CPT) met the selection criteria. Results support the use of the expiratory flow increase technique and CPT, especially manual hyperinflation and vibrations, for secretion clearance. Evidence does not support the routine use of either CPT or suction alone. No studies investigating rehabilitation in PICU met selection criteria.
Limitations
A lack of high level evidence was available to inform this review.
Conclusion
Evidence indicates that CPT is still the focus of physiotherapy intervention in PICU for mechanically ventilated patients, and supports its use for secretion clearance in this setting.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=134243
in Physiotherapy > 2015/4 (2015) . - pp. 303-309[article]
Titre : Early Mobilization Reduces Duration of Mechanical Ventilation and Intensive Care Unit Stay in Patients With Acute Respiratory Failure Type de document : Article Auteurs : Chih-Cheng Lai ; Willy Chou ; Khee-Siang Chan Article en page(s) : pp. 931-939 Langues : Anglais (eng) Descripteurs : HE Vinci
Rééducation et réadaptation ; Respiration ; Unités de soins intensifs ; Ventilation artificielleMots-clés : Intensive care units Artificial Résumé : Objective
To evaluate the effects of a quality improvement program to introduce early mobilization on the outcomes of patients with mechanical ventilation (MV) in the intensive care unit (ICU).
Design
A retrospective observational study.
Setting
Nineteen-bed ICU at a medical center.
Participants
Adults patients with MV (N=153) admitted to a medical ICU.
Interventions
A multidisciplinary team (critical care nurse, nursing assistant, respiratory therapist, physical therapist, patient's family) initiated the protocol within 72 hours of MV when patients become hemodynamically stable. We did early mobilization twice daily, 5d/wk during family visits (30min each time), and cooperated with family, if possible.
Main Outcome Measures
MV duration, rate of successful weaning, and length of ICU and hospital stay.
Results
We enrolled 63 patients in the before protocol group and 90 in the after protocol group. The 2 groups were well matched in age, sex, body height, body weight, body mass index, disease severity, cause of intubation, number of comorbidities, and most underlying diseases. After protocol group patients had shorter MV durations (4.7d vs 7.5d; P<.001 and icu stays vs p=".001)" than did before protocol group patients. early mobilization was negatively associated with the duration of mv confidence interval to risk for days lower in patients who underwent ratio .082 ci .021> Conclusions
The introduction of early mobilization for patients with MV in the ICU shortened MV durations and ICU stays. A multidisciplinary team that includes the patient's family can work together to improve the patient's clinical outcomes.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117746
in Archives of Physical Medicine and Rehabilitation > 2017/5 (2017) . - pp. 931-939[article]
Titre : Intensive Early Rehabilitation in the Intensive Care Unit for Liver Transplant Recipients: A Randomized Controlled Trial Type de document : Article Auteurs : Pierre Maffei ; Sandrine Wiramus ; Laurent Bensoussan Article en page(s) : pp. 1518–1525 Langues : Anglais (eng) Descripteurs : HE Vinci
Rééducation et réadaptation ; Transplantation hépatique ; Unités de soins intensifsMots-clés : Intensive care units Liver transplantation Résumé : Objective
To validate the feasibility and tolerance of an intensive rehabilitation protocol initiated during the postoperative period in an intensive care unit (ICU) in liver transplant recipients.
Design
Prospective randomized study.
Setting
ICU.
Participants
Liver transplant recipients over a period of 1 year (N=40).
Interventions
The “usual treatment group” (n=20), which benefited from the usual treatment applied in the ICU (based on physician prescription for the physiotherapist, with one session a day), and the experimental group (n=20), which followed a protocol of early and intensive rehabilitation (based on a written protocol validated by physicians and an evaluation by physiotherapist, with 2 sessions a day), were compared.
Main Outcome Measures
Our primary aims were tolerance, assessed from the number of adverse events during rehabilitation sessions, and feasibility, assessed from the number of sessions discontinued.
Results
The results revealed a small percentage of adverse events (1.5% in the usual treatment group vs 1.06% in the experimental group) that were considered to be of low intensity. Patients in the experimental group sat on the edge of their beds sooner (2.6 vs 9.7d; P=.048) and their intestinal transit resumed earlier (5.6 vs 3.7d; P=.015) than patients in the usual treatment group. There was no significant difference between the 2 arms regarding length of stay (LOS), despite a decrease in duration in the experimental group.
Conclusions
The introduction of an intensive early rehabilitation program for liver transplant recipients was well tolerated and feasible in the ICU. We noted that the different activities proposed were introduced sooner in the experimental group. Moreover, there is a tendency to decreased LOS in the ICU for the experimental group. These results now need to be confirmed by studies on a larger scale.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=118170
in Archives of Physical Medicine and Rehabilitation > 2017/8 (2017) . - pp. 1518–1525[article]
Titre : Effect of an Evidence-Based Mobility Intervention on the Level of Function in Acute Intracerebral and Subarachnoid Hemorrhagic Stroke Patients on a Neurointensive Care Unit Type de document : Article Auteurs : Maxine L. Rand ; Jeanne A. Darbinian Article en page(s) : p. 1191–1199 Langues : Anglais (eng) Descripteurs : HE Vinci
Accident vasculaire cérébral (AVC) ; Durée du séjour ; Mobilité réduite ; Rééducation et réadaptation ; Unités de soins intensifsMots-clés : Intensive Care Units Length of stay Mobility limitation Stroke Subarachnoid hemorrhage Hémorragie meningée Walking Marche à pied Résumé : Objectives
To explore the effect of an evidence-based mobility intervention on the level of function (LOF) achieved by patients with intracerebral hemorrhage (ICH) stroke and subarachnoid hemorrhage (SAH) stroke and to identify clinical characteristics and measures associated with walking distances >15.24m.
Design
Retrospective pre- and postintervention study.
Setting
Regional neurointensive care unit.
Participants
Adult patients with ICH and SAH (N=361).
Intervention
Daily mobility intervention based on patient's current LOF.
Main Outcome Measure
Walking >15.24m (LOF 5) by neurointensive care unit discharge.
Results
Electronic health records for 361 patients (52.6% women; mean age, 62.1y; ICH stroke, 63.2%; aphasia, 35%; hemiplegia, 33%) were included. There was a 2.3-fold increase in patients with hemorrhagic stroke achieving a LOF of 5 by neurointensive care unit discharge after introduction of a mobility intervention. In the multivariable logistic regression model including neurointensive care unit length of stay (LOS) as a covariate, the intervention, LOF of 5 at admission, SAH stroke type, third (vs lowest) quartile of neurointensive care unit LOS, and absence of aphasia and/or hemiplegia were associated with higher likelihood of achieving a LOF of 5 (odds ratio [OR]=5.28; 95% confidence interval [CI], 2.52–11.06; OR=6.02; 95% CI, 1.45–24.96; OR=3.78; 95% CI, 1.83–7.80; OR=2.94; 95% CI, 1.16–7.47; OR=17.77; 95% CI, 6.59–47.92, respectively).
Conclusions
A mobility intervention was strongly associated with increased distance walked by neurointensive care unit patients with acute hemorrhage at discharge and can be applied in any intensive care unit setting to promote stroke recovery. Future studies directed at building predictive models for walking achievement in patients with acute hemorrhagic stroke may provide insight into individualized treatment goal setting and discharge planning.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=118346
in Archives of Physical Medicine and Rehabilitation > 2015/7 (2015) . - p. 1191–1199[article]PermalinkPermalinkPermalink
