Interventions for preventing critical illness polyneuropathy and critical illness myopathy

Abstract

Substantial evidence shows that intensive insulin therapy reduces the incidence of CIP/CIM, the duration of mechanical ventilation, duration of ICU stay and 180-day mortality. There was a significant associated increase in hypoglycaemia. Further research needs to identify the clinical impact of this and strategies need to be developed to reduce the risk of hypoglycaemia. Limited evidence shows no significant effect of corticosteroids on the incidence of CIP/CIM, or on any of the other secondary outcome measures, except for a significant reduction of new episodes of shock. Strict diagnostic criteria for the purpose of research should be defined. Other interventions should be investigated in randomised controlled trials.

Characteristics of patients readmitted to intensive care unit: a nested case-control study

“…They were also at risk of hypoventilation and type 2 respiratory failures. 22,23 Similar findings were reported in patients with severe head trauma. 24,25 In our cohort, patients with neurological diseases constituted the highest proportion of readmissions.…”

Characteristics of patients readmitted to intensive care unit: a nested case-control study

“…They were also at risk of hypoventilation and type 2 respiratory failures. 22,23 Similar findings were reported in patients with severe head trauma. 24,25 In our cohort, patients with neurological diseases constituted the highest proportion of readmissions.…”

The Feasibility of High-Intensity Interval Training in Patients with Intensive Care Unit-Acquired Weakness Syndrome Following Long-Term Invasive Ventilation

“…The lack of a difference in our primary study outcome (6 MWT) may be explained by several aspects: (1) training duration may have been too short, whereby extending our 3-week training programme to 6 or even 8 weeks may have led to more pronounced physiological adaptations; (2) subjective reporting of dyspnea-which Although no significant between-group differences were detected in the secondary outcome, functional scores (Barthel and FIM/FAM), lung function testing and inspiratory muscle force markedly increased in HIIT and MCT after 3 weeks. This goes along with studies showing a beneficial effect of early and short-term ICU rehabilitation on inspiratory muscle capacity, lung function and functionality [21,44,45], both after cardiological [46][47][48] and pneumological [49,50] events. However, a Cochrane review has pointed out that insufficient data exists on the long-term benefits of early rehabilitation in ICUAWS and the correct dosing of interventions is widely unknown [2,45].…”

“…This goes along with studies showing a beneficial effect of early and short-term ICU rehabilitation on inspiratory muscle capacity, lung function and functionality [21,44,45], both after cardiological [46][47][48] and pneumological [49,50] events. However, a Cochrane review has pointed out that insufficient data exists on the long-term benefits of early rehabilitation in ICUAWS and the correct dosing of interventions is widely unknown [2,45]. To date, no evidence of a survival benefit of early rehabilitation has been found in ICU patients.…”

“…Although no significant between-group differences were detected in the secondary outcome, functional scores (Barthel and FIM/FAM), lung function testing and inspiratory muscle force markedly increased in HIIT and MCT after 3 weeks. This goes along with studies showing a beneficial effect of early and short-term ICU rehabilitation on inspiratory muscle capacity, lung function and functionality [ 21 , 44 , 45 ], both after cardiological [ 46 – 48 ] and pneumological [ 49 , 50 ] events. However, a Cochrane review has pointed out that insufficient data exists on the long-term benefits of early rehabilitation in ICUAWS and the correct dosing of interventions is widely unknown [ 2 , 45 ].…”

Predictors of Postoperative Rehabilitation Therapy Following Congenital Heart Surgery

“…Financial analysis models have shown that investment in early rehabilitation programs in the intensive care unit for adults has the potential to generate substantial net cost savings for hospitals while improving patient outcomes. 27 While deconditioning and critical neuropathy are the biggest issues in adult postcardiac surgery patients, 28,29 our data highlight the important differences in the adult patient population in whom PT is the most common therapy used compared with patients following congenital heart surgery where they might need a combination of interventions. Thus, pediatric cardiac rehabilitation programs have to be multidisciplinary and personally tailored not only by the type of CHD but also by age.…”

Characteristics of patients readmitted to intensive care unit: a nested case-control study

“…They were also at risk of hypoventilation and type 2 respiratory failures. 22,23 Similar findings were reported in patients with severe head trauma. 24,25 In our cohort, patients with neurological diseases constituted the highest proportion of readmissions.…”

The Feasibility of High-Intensity Interval Training in Patients with Intensive Care Unit-Acquired Weakness Syndrome Following Long-Term Invasive Ventilation

“…The lack of a difference in our primary study outcome (6 MWT) may be explained by several aspects: (1) training duration may have been too short, whereby extending our 3-week training programme to 6 or even 8 weeks may have led to more pronounced physiological adaptations; (2) subjective reporting of dyspnea-which Although no significant between-group differences were detected in the secondary outcome, functional scores (Barthel and FIM/FAM), lung function testing and inspiratory muscle force markedly increased in HIIT and MCT after 3 weeks. This goes along with studies showing a beneficial effect of early and short-term ICU rehabilitation on inspiratory muscle capacity, lung function and functionality [21,44,45], both after cardiological [46][47][48] and pneumological [49,50] events. However, a Cochrane review has pointed out that insufficient data exists on the long-term benefits of early rehabilitation in ICUAWS and the correct dosing of interventions is widely unknown [2,45].…”

“…This goes along with studies showing a beneficial effect of early and short-term ICU rehabilitation on inspiratory muscle capacity, lung function and functionality [21,44,45], both after cardiological [46][47][48] and pneumological [49,50] events. However, a Cochrane review has pointed out that insufficient data exists on the long-term benefits of early rehabilitation in ICUAWS and the correct dosing of interventions is widely unknown [2,45]. To date, no evidence of a survival benefit of early rehabilitation has been found in ICU patients.…”

“…Although no significant between-group differences were detected in the secondary outcome, functional scores (Barthel and FIM/FAM), lung function testing and inspiratory muscle force markedly increased in HIIT and MCT after 3 weeks. This goes along with studies showing a beneficial effect of early and short-term ICU rehabilitation on inspiratory muscle capacity, lung function and functionality [ 21 , 44 , 45 ], both after cardiological [ 46 – 48 ] and pneumological [ 49 , 50 ] events. However, a Cochrane review has pointed out that insufficient data exists on the long-term benefits of early rehabilitation in ICUAWS and the correct dosing of interventions is widely unknown [ 2 , 45 ].…”

Predictors of Postoperative Rehabilitation Therapy Following Congenital Heart Surgery

“…Financial analysis models have shown that investment in early rehabilitation programs in the intensive care unit for adults has the potential to generate substantial net cost savings for hospitals while improving patient outcomes. 27 While deconditioning and critical neuropathy are the biggest issues in adult postcardiac surgery patients, 28,29 our data highlight the important differences in the adult patient population in whom PT is the most common therapy used compared with patients following congenital heart surgery where they might need a combination of interventions. Thus, pediatric cardiac rehabilitation programs have to be multidisciplinary and personally tailored not only by the type of CHD but also by age.…”

Characteristics of patients readmitted to intensive care unit: a nested case-control study

“…They were also at risk of hypoventilation and type 2 respiratory failures. 22,23 Similar findings were reported in patients with severe head trauma. 24,25 In our cohort, patients with neurological diseases constituted the highest proportion of readmissions.…”

The Feasibility of High-Intensity Interval Training in Patients with Intensive Care Unit-Acquired Weakness Syndrome Following Long-Term Invasive Ventilation

“…The lack of a difference in our primary study outcome (6 MWT) may be explained by several aspects: (1) training duration may have been too short, whereby extending our 3-week training programme to 6 or even 8 weeks may have led to more pronounced physiological adaptations; (2) subjective reporting of dyspnea-which Although no significant between-group differences were detected in the secondary outcome, functional scores (Barthel and FIM/FAM), lung function testing and inspiratory muscle force markedly increased in HIIT and MCT after 3 weeks. This goes along with studies showing a beneficial effect of early and short-term ICU rehabilitation on inspiratory muscle capacity, lung function and functionality [21,44,45], both after cardiological [46][47][48] and pneumological [49,50] events. However, a Cochrane review has pointed out that insufficient data exists on the long-term benefits of early rehabilitation in ICUAWS and the correct dosing of interventions is widely unknown [2,45].…”

“…This goes along with studies showing a beneficial effect of early and short-term ICU rehabilitation on inspiratory muscle capacity, lung function and functionality [21,44,45], both after cardiological [46][47][48] and pneumological [49,50] events. However, a Cochrane review has pointed out that insufficient data exists on the long-term benefits of early rehabilitation in ICUAWS and the correct dosing of interventions is widely unknown [2,45]. To date, no evidence of a survival benefit of early rehabilitation has been found in ICU patients.…”

“…Although no significant between-group differences were detected in the secondary outcome, functional scores (Barthel and FIM/FAM), lung function testing and inspiratory muscle force markedly increased in HIIT and MCT after 3 weeks. This goes along with studies showing a beneficial effect of early and short-term ICU rehabilitation on inspiratory muscle capacity, lung function and functionality [ 21 , 44 , 45 ], both after cardiological [ 46 – 48 ] and pneumological [ 49 , 50 ] events. However, a Cochrane review has pointed out that insufficient data exists on the long-term benefits of early rehabilitation in ICUAWS and the correct dosing of interventions is widely unknown [ 2 , 45 ].…”

Predictors of Postoperative Rehabilitation Therapy Following Congenital Heart Surgery

“…Financial analysis models have shown that investment in early rehabilitation programs in the intensive care unit for adults has the potential to generate substantial net cost savings for hospitals while improving patient outcomes. 27 While deconditioning and critical neuropathy are the biggest issues in adult postcardiac surgery patients, 28,29 our data highlight the important differences in the adult patient population in whom PT is the most common therapy used compared with patients following congenital heart surgery where they might need a combination of interventions. Thus, pediatric cardiac rehabilitation programs have to be multidisciplinary and personally tailored not only by the type of CHD but also by age.…”