Functional status after intensive care: A challenge for rehabilitation professionals to improve outcome

Schaaf, Marike van der; Beelen, Anita; Dongelmans, Dave A.; Vroom, Margreeth B.; Nollet, Frans

doi:10.2340/16501977-0333

Cited by 102 publications

(51 citation statements)

References 29 publications

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“…[7][8][9] Immobility, depression, and cognitive and neuromuscular impairments have been postulated as risk factors for long-term PF impairment in survivors of critical illness. 10 Post-ICU PF impairments are a major burden for patients, their families, and the health-care system because of high rates of institutionalization, frequent repeat hospitalizations, and other increased health-care services use.…”

mentioning

confidence: 99%

Interventions to Improve the Physical Function of ICU Survivors

Calvo-Ayala

Khan

Farber

et al. 2013

Chest

130

103

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1469CHEST ments. [7][8][9] Immobility, depression, and cognitive and neuromuscular impairments have been postulated as risk factors for long-term PF impairment in survivors of critical illness. 10 Post-ICU PF impairments are a major burden for patients, their families, and the health-care system because of high rates of institutionalization, frequent repeat hospitalizations, and other increased health-care services use. 10 There has been enhanced interest in studying the etiology, pathophysiology, prevention, and treatment of PF impairment of ICU survivors, 11 punctuated by the publication of three systematic reviews (SRs) in this fi eld. 12-14 Two of these reviews focused on describing the frequency, clinical features, and short-term outcomes (mortality, duration of mechanical ventilation, and length of hospitalization) related to the occurrence of neuromuscular abnormalities related M ore than 4 million ICU admissions occur annually in the United States. 1 ICU beds account for 10% of all hospital beds and result in at least 20% of hospital operating costs amounting to $90 billion annually. 2 Since our population is progressively aging, and most ICU patients are . 65 years of age, ICU care is expected to keep expanding in the next 2 decades. 3,4 This increase in the numbers of critically ill patients, along with improvement in ICU mortality, is creating a growing number of ICU survivors. 5 ICU survivors suffer from a variety of serious sequelae following their ICU stay, including late mortality, ongoing morbidity, neurocognitive defects, impaired mental health, poor functional capabilities, decreased quality of life, and decreased return to work and usual activities. 6 Up to 69% of ICU survivors have clinically important long-term physical function (PF) impair-

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confidence: 99%

Interventions to Improve the Physical Function of ICU Survivors

Calvo-Ayala

Khan

Farber

et al. 2013

Chest

130

103

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“…In a recent study [42] in COPD patients admitted to the ICU, 73% of the patients considered their HRQOL to be comparable or even better at 6 months after treatment than it had been in the stable period before their ICU admission. However, in another recent study [43 ] 1 year after ICU discharge, patients had strong limitations in physically related activities.…”

Section: Assessing the Impact Of Critical Illness On Health-related Qmentioning

confidence: 95%

Health-related quality of life in critically ill patients: how to score and what is the clinical impact?

Hofhuis

Stel

Schrijvers

et al. 2009

Current Opinion in Critical Care

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In this article, we reviewed the methods and description of measurement instruments used in critically ill patients. The most recently used instruments to measure HRQOL, how to score HRQOL before ICU admission and the impact of critical illness on HRQOL are discussed. Assessment of HRQOL can improve the answers given by critical care physicians and nurses about the prospects of their patients. To get insights in these issues regarding the impact of ICU treatment, we should incorporate not only short-term outcomes, for example length of stay and mortality, but also HRQOL.

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“…1,2 Critically ill patients suffer profound impairments that may persist for months following intensive care unit (ICU) admission. A survey of patients admitted to a Dutch ICU 2 for more than 48 hours revealed that 12 months following admission, 32% of subjects demonstrated Sickness Impact Profile 68 scores suggesting clear disablement in daily activities.…”

Section: Introductionmentioning

confidence: 99%

Physiotherapy led early rehabilitation of the patient with critical illness

Thomas

2011

Physical Therapy Reviews

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Background: Studies revealing the effectiveness of physical rehabilitation techniques provided during a critical care admission have been hampered by experimental control issues and ethical constraints. However, because of worldwide variations in physiotherapy practice, differences in patient outcomes can be investigated when physical rehabilitation is provided immediately upon critical care admission compared to rehabilitation initiated after extubation, after withdrawal of mechanical ventilation, after discharge from the acute environment or not at all. Objectives: The purpose of this review is to examine reports describing the effects of physical rehabilitation which is commenced immediately on critical care admission compared to rehabilitation which is delayed. Major findings: Overall, early initiation of rehabilitation reveals an increased incidence of physiotherapy consultation, decreased time to achieve activity milestones, improved functional outcomes at intensive care unit and hospital discharge and reduced direct patient costs. Where early rehabilitation is already a key component of care for critically ill patients, research has concentrated on determining the acute physiological effects of interventions, or the impact of providing additional specific therapies to overall functional and administrative outcomes. Conclusions: Early physiotherapy led rehabilitation of the critically ill patient has the potential to dramatically influence recovery and functional outcomes in this vulnerable patient group.

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Functional status after intensive care: A challenge for rehabilitation professionals to improve outcome

Cited by 102 publications

References 29 publications

Interventions to Improve the Physical Function of ICU Survivors

Interventions to Improve the Physical Function of ICU Survivors

Health-related quality of life in critically ill patients: how to score and what is the clinical impact?

Physiotherapy led early rehabilitation of the patient with critical illness

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