Intensive Care Unit-Acquired Weakness

Harvey, Nina R.; Stanton, Marietta P.

doi:10.1097/ncm.0000000000000192

Cited by 4 publications

(1 citation statement)

References 20 publications

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“…Paying attention to clinical ICU-AW outcomes can affect patients’ performance. Health managers can use knowledge about ICU-AW and muscle conditions to improve patients' conditions in hospitals and prevent unnecessary use of health care resources [ 72 ]. Therefore, health managers should consider the importance and improvement of the ICU-AW-prone patients admitted to ICUs.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of massage and range of motion exercises on muscle strength and intensive care unit-acquired weakness in Iranian patients with COVID-19: a randomized parallel-controlled trial

Zakeri,

Aziz,

Rahiminezhad

et al. 2024

ACC

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Background: Muscle weakness is prevalent in intensive care patients. This study focused on comparing the effects of massage and range of motion (ROM) exercises on muscle strength and intensive care unit-acquired weakness (ICU-AW) among patients with coronavirus disease 2019 (COVID-19). Methods: This study was a randomized clinical trial that recruited patients (n=45) with COVID-19 admitted to the ICU and divided them into three groups (ROM exercises, massage, and control). We evaluated muscle strength and ICU-AW in the arms and legs using a hand dynamometer. The Medical Research Council sum score was determined before and after the intervention. Results: The study findings were that 0%, 20%, and 100% of the participants in the ROM exercises, massage, and control groups had ICU-AW on the 7th day of ICU admission. The ROM exercise group had greater muscle strength in the hands and legs than the massage and control groups, and the massage group had greater muscle strength than the control group. Conclusions: Massage and ROM exercises could improve muscle strength and reduce ICU-AW in COVID-19 patients admitted to the ICU.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of massage and range of motion exercises on muscle strength and intensive care unit-acquired weakness in Iranian patients with COVID-19: a randomized parallel-controlled trial

Zakeri,

Aziz,

Rahiminezhad

et al. 2024

ACC

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Fragmentierung des Fallmanagements in deutschen Krankenhausabteilungen

Holderried

Wolpert

Zenner

et al. 2018

Gesundh ökon Qual manag

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Zusammenfassung Hintergrund Wesentliche Ziele von Krankenhäusern sind eine hohe Qualität, Sicherheit, Effektivität und Effizienz der Leistungserbringung. Dies erfordert eine optimale Behandlungssteuerung durch das Fallmanagement auf den Krankenhausstationen (FM). Methoden Für eine Analyse der Mikro- und Makroprozesse des stationären Fallmanagements wurde ein strukturiertes Interviewinventar entwickelt. Anschließend wurde mit dem Interviewinventar eine Felduntersuchung als community based participatory research (CBPR) an homogenen Fokusgruppen von 24 deutschen, aus ökonomischer Sicht als Profitcenter wirkenden, öffentlichen Krankenhausabteilungen der Maximalversorgung durchgeführt. Ergebnisse Mit der CBPR-Feldstudie konnten 1.682 Mikroprozesse des stationären Fallmanagements der untersuchten Krankenhausabteilungen erfasst und beurteilt werden. Die Studie zeigt, dass alle Abteilungen zwar ein umfangreiches klinisches Fallmanagement betreiben, die Mikroprozesse des Fallmanagements allerdings durchgehend weder optimal zur Kostenminimierung noch maximal zur Liquiditäts-, Erlös- und Qualitätsverbesserung durchgeführt werden. Auch zeigt sich, dass die berufsgruppenübergreifende Durchführung der Prozesse des FM durch Ärzte und Pflegekräfte mit einer erheblichen Fragmentierung des FM verbunden ist. Schlussfolgerungen Die intensive Fragmentierung der Tätigkeiten des FM auf Krankenhausstationen legt die Erarbeitung von Strategien nahe, die Prozesse des stationären Fallmanagements zu homogenisieren.

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Meta-analysis of the effects of bundle interventions on ICU-acquired weakness intervention

Zhou,

Liu,

Han

et al. 2024

THC

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BACKGROUND: Intensive care unit acquired weakness (ICU-AW) is a secondary neuromuscular complication in critically ill patients, characterized by profound weakness in all four limbs. Studies have shown that bundles of care are nursing strategies that combine a series of evidence-based interventions, which collectively optimize patients’ clinical outcomes compared to individual interventions. OBJECTIVE: This study aims to conduct a meta-analysis of the effects of bundle interventions on ICU-AW deeply exploring the characteristics of bundle interventions, patient outcomes related to ICU-AW, and primarily investigating the effects of bundle interventions on ICU-AW. The main focus is to explore the clinical value of bundle interventions in treatment of ICU-acquired weakness in patients. METHODS: Computer and manual searches were conducted using keywords to retrieve relevant studies on the effects of bundle interventions on ICU-AW from databases such as PubMed, Web of Science, Cochrane Library and EMbase. The search period ranged from database inception to the present. The control group received standard ICU care, including basic nursing, while the intervention group received bundle nursing interventions. RESULTS: A total of 10 randomized controlled trials (RCTs) involving 1545 participants (790 in the intervention group and 755 in the control group) were included. Meta-analysis results showed that the intervention group had significantly higher muscle strength (MD = 7.41, 95% CI: 6.65–8.16, P< 0.00001) and daily living ability (MD = 34.01, 95% CI: 32.54–35.48, P< 0.00001) than the control group. Additionally, the incidence of ICU-AW (OR = 0.39, 95% CI: 0.26–0.59, P< 0.00001), mechanical ventilation time (MD =-3.71, 95% CI: -3.58∼-2.76, P< 0.0001), and ICU length of stay (MD =-2.73, 95% CI: -3.14∼-2.31, P< 0.00001) were significantly lower in the intervention group than in the control group. CONCLUSION: ICU-AW has a severe negative impact on the recovery and functional restoration of ICU patients, increasing the treatment complexity for healthcare providers and the mortality and disability rates for patients. The bundled care approach may help reduce the incidence of ICU-AW, promote the restoration of daily activity function, enhance muscle strength, and reduce ICU stay and mechanical ventilation time for ICU patients. However, the long-term effects of bundle interventions still require further in-depth research.

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Intensive Care Unit-Acquired Weakness

Cited by 4 publications

References 20 publications

Effectiveness of massage and range of motion exercises on muscle strength and intensive care unit-acquired weakness in Iranian patients with COVID-19: a randomized parallel-controlled trial

Effectiveness of massage and range of motion exercises on muscle strength and intensive care unit-acquired weakness in Iranian patients with COVID-19: a randomized parallel-controlled trial

Fragmentierung des Fallmanagements in deutschen Krankenhausabteilungen

Meta-analysis of the effects of bundle interventions on ICU-acquired weakness intervention

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