Intensive care unit-acquired weakness: Questions the clinician should ask

Tortuyaux, Romain; Davion, J-B; Jourdain, M.

doi:10.1016/j.neurol.2021.12.007

Cited by 22 publications

(19 citation statements)

References 66 publications

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“…In terms of other complications, significantly fewer cases of DVT, PSs, and VAP were determined in the Res, demonstrating that early multidisciplinary collaboration model can help CIPs prevent these four complications, which is consistent with the report of Zang et al [ 28 ]. The risk factors of ICU-AW in CIPs are known not only related to disease severity, organ failure, and age but also to prolonged immobilization and malnutrition [ 29 ]. Under the intervention of early multidisciplinary collaboration, CIPs were provided with rehabilitation training, nutritional support, posture guidance, and psychological counseling based on the specific condition of patients, all of which play a certain role in preventing complications and help patients build confidence in overcoming the disease, contributing to early rehabilitation of CIPs.…”

Section: Discussionmentioning

confidence: 99%

Influence of Early Multidisciplinary Collaboration on Prevention of ICU-Acquired Weakness in Critically Ill Patients

Wang

Tian

et al. 2022

Disease Markers

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Objective. This study focused on elucidating the influence of early multidisciplinary collaboration on preventing intensive care unit- (ICU-) acquired weakness (AW) in critically ill patients (CIPs). Methods. Ninety-five CIPs admitted between December 2018 and December 2021 were selected and assigned to the following two groups according to the intervention pattern: the control group (the Con; n = 40 ) treated with routine early rehabilitation intervention, and the research group (the Res; n = 55 ) intervened by early multidisciplinary collaborative intervention. The incidence of complications (ICU-AW, deep vein thrombosis (DVT), and pressure ulcers (PSs)) and recovery indices (days of ventilator use, ICU treatment time, and length of hospital stay (LOS)) were recorded. Besides, patients’ activity function and quality of life (QoL) were evaluated and compared, among which the former was evaluated by the Barthel Index (BI), ICU Mobility Scale (IMS), and Medical Research Council (MRC) Scale, and the latter was assessed by the World Health Organization Quality of Life Assessment (100-item version) (WHOQOL-100). Results. The data identified statistically a lower incidence of complications (ICU-AW, DVT, and PSs) and shorter time of ventilator use, ICU residence, and LOS in the Res compared with the Con. In addition, BI, IMS, MRC, and WHOQOL-100 scores in the Res elevated statistically after treatment and were higher than those of the Con. Conclusions. Early multidisciplinary collaboration can validly prevent ICU-AW in CIPs, reduce the incidence of DVT and PSs, and promote patients’ rehabilitation, mobility, and QoL.

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Section: Discussionmentioning

confidence: 99%

Influence of Early Multidisciplinary Collaboration on Prevention of ICU-Acquired Weakness in Critically Ill Patients

Wang

Tian

et al. 2022

Disease Markers

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Section: Discussionmentioning

confidence: 99%

“…some studies suggested that ICU-AW may occur within several hours after patients receiving mechanical ventilation, the early intervention can reduce incidence of ICU-AW, and the earlier intervention can achieve the better effect. [10][11][12] So it has an important clinical value to explore an optimum proposal for early progressive mobilization. [13] In this study, The MRC score and Barthel index score of the intervention group were significantly higher than those of the control group, suggesting that early progressive mobilization can effectively improve the muscle weakness.…”

Section: Discussionmentioning

confidence: 99%

Effect of early progressive mobilization on intensive care unit-acquired weakness in mechanically ventilated patients: An observational study

Zhou¹,

Zhang²,

Zhou³

et al. 2022

Medicine

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Early progressive mobilization is usually considered as an effective method for intensive care unit-acquired weakness (ICU-AW), but the controversies on this topic remain debatable, especially in initiation time, safety profile, and other implementation details. So, more studies should be performed to solve these disputes. A set of critically ill patients underwent mechanical ventilation in intensive care unit (ICU) of our hospital from March 2018 to September 2020 were included as study object. Patients received early progressive mobilization were included into the intervention group (n = 160), and another patients matched with the intervention group by gender, age, and APACHE II score, and these patients received routine intervention were included into the control group (n = 160). Then, indexes involving muscle strength, Barthel index, functional independence, incidence rates of ICU-AW and other complications were comparatively analyzed between the 2 groups. The Medical Research Council score and Barthel index score in the intervention group were significantly higher than those in the control group (all P < .05). The percentages of patients who were able to complete taking a shower, wearing clothes, eating, grooming, moving from bed to chair and using the toilet by alone in the intervention group were significantly higher than those in the control group (69.38% vs 49.38%, 73.13% vs 51.88%, 81.25% vs 55.63%, 74.38% vs 48.75%, 82.50% vs 65.63%, 78.13% vs 63.13%, respectively, all P < .05). The incidence rate of ICU-AW and overall incidence rate of complications in the intervention group were significantly lower than those in the control group (6.88% vs 28.13% and 23.13% vs 48.13%, both P < .05). Early progressive mobilization can effectively increase muscle strength and daily basic motion ability, improve functional status, and decrease risk of ICU-AW in critically ill patients underwent mechanical ventilation, and it has an attractive application value in clinic.

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“…Risk factors for developing ICU-AW include female sex, mechanical ventilation days, age, infectious disease, increased organ failure score, hyperglycaemia and renal replacement therapy [21 ▪ ]. Assessing ICU-AW at the bedside continues to be a useful clinical tool to identify patients with increased care requirements in hospital and after hospital discharge [1,22]. The majority of rehabilitation trials have measured muscle strength along with quality of life, and other patient-centred outcomes at either ICU or hospital discharge.…”

Section: Icu-acquired Weakness and Patient-centred Outcomesmentioning

confidence: 99%

Physical rehabilitation, mobilization and patient-centred outcomes: what is new?

Broadley,

Higgins,

Hodgson

2023

Current Opinion in Critical Care

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Purpose of review Physical rehabilitation and mobilization interventions aim to reduce the incidence of intensive care unit (ICU)-acquired weakness and subsequently reduce morbidity in critically ill patients. This chapter will explore the evidence for physical rehabilitation and mobilization with an emphasis on patient-centred outcomes selected in randomized controlled trials. This is particularly pertinent at a time when clinicians are deciding how to implement physical rehabilitation and mobilization into the treatment of critically ill patients. Recent findings Multiple trials of physical rehabilitation and mobilization were published in 2022 and 2023 with conflicting results. Analysing the complexities of physical rehabilitation research provides an insight into these results and will aid in the interpretation of trials of physical rehabilitation and mobilization. Summary Patient-centred outcomes are often utilized in physical rehabilitation and mobilization research, but this does not automatically correspond to an increase in research quality. Improving consistency in trials of physical rehabilitation will aid in the interpretation and translation of physical rehabilitation research.

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Intensive care unit-acquired weakness: Questions the clinician should ask

Cited by 22 publications

References 66 publications

Influence of Early Multidisciplinary Collaboration on Prevention of ICU-Acquired Weakness in Critically Ill Patients

Influence of Early Multidisciplinary Collaboration on Prevention of ICU-Acquired Weakness in Critically Ill Patients

Effect of early progressive mobilization on intensive care unit-acquired weakness in mechanically ventilated patients: An observational study

Physical rehabilitation, mobilization and patient-centred outcomes: what is new?

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