The effects of active mobilisation and rehabilitation in ICU on mortality and function: a systematic review

Tipping, Claire J; Harrold, Megan; Holland, Anne E; Romero, Lorena; Nisbet, Travis; Hodgson, Carol

doi:10.1007/s00134-016-4612-0

Cited by 445 publications

(347 citation statements)

References 37 publications

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“…A recent meta-analysis reported that early rehabilitation in the ICU did not reduce short-term and long-term mortality but improved mobility status and muscle strength [19]. Initiation of rehabilitation during ICU stay was an independent factor affecting physical status in our study.…”

Section: Effects Of Nutritional Management and Rehabilitation On Physsupporting

confidence: 51%

“…Thus, rehabilitation in the ICU is important for critically ill patients to improve physical function. We think that further studies regarding the effect of early rehabilitation on mortality are needed because all 10 RCTs that included a meta-analysis did not show that rehabilitation reduces mortality [19].…”

Section: Effects Of Nutritional Management and Rehabilitation On Physmentioning

confidence: 99%

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Influence of Nutritional Management and Rehabilitation on Physical Outcome in Japanese Intensive Care Unit Patients: A Multicenter Observational Study

et al. 2018

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Background: There is lack of evidence regarding nutritional management among intensive care unit (ICU) patients in a population with relatively low body mass index. Therefore, we conducted an observational study to assess the nutritional management in Japanese ICUs. Also, we investigated the impact of nutritional management and rehabilitation on physical outcome. Methods: The study population comprised 389 consecutive patients who received mechanical ventilation for at least 24 h and those admitted to the ICU for > 72 h in 13 hospitals. The primary outcomes were caloric and protein intake in ICU on days 3 and 7, and at ICU discharge. The secondary outcome was the impact of nutritional management and rehabilitation on physical status at ICU discharge. We defined good physical status as more than end sitting and poor physical status as bed rest and sitting. We divided the participants into 2 groups, namely, the good physical status group (Good group) and poor physical status group (Poor group) for analysis of the secondary outcome. Data were expressed as median (interquartile range). Results: The median amount of caloric intake on days 3 and 7, and at ICU discharge via enteral and parenteral routes were 8.4 (3.1–15.6), 14.9 (7.5–22.0), and 11.2 (2.5–19.1) kcal/kg/day, respectively. The median amount of protein intake on days 3 and 7, and at ICU discharge were 0.2 (0–0.5), 0.4 (0.1–0.8), and 0.3 (0–0.7) g/kg/day, respectively. The amount of caloric intake on day 3 in the Poor group was significantly higher than that of the Good group (10.1 [5.8, 16.2] vs. 5.2 [1.9, 12.4] kcal/kg/day, p < 0.001). The proportion of patients who were received rehabilitation in ICU in the Good group was significantly higher than that of the Poor group (92 vs. 63%, p < 0.001). The multivariate analysis revealed that caloric intake on day 3 and rehabilitation in ICU were considered independent factors that affect physical status (OR 1.19; 95% CI 1.05–1.34; p = 0.005 and OR 0.07; 95% CI 0.01–0.34; p = 0.001). Conclusions: The caloric and protein intakes in Japanese ICUs were 15 kcal/kg/day and 0.4 g/kg/day, respectively. In addition, critically ill patients might benefit from low caloric intake (less than 10 kcal/kg/day) until day 3 and rehabilitation during ICU stay.

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Section: Effects Of Nutritional Management and Rehabilitation On Physsupporting

confidence: 51%

Section: Effects Of Nutritional Management and Rehabilitation On Physmentioning

confidence: 99%

Influence of Nutritional Management and Rehabilitation on Physical Outcome in Japanese Intensive Care Unit Patients: A Multicenter Observational Study

et al. 2018

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“…However, prolonged immobility exposes the patient to exacerbated muscle weakness and poor long-term outcomes. A recent systematic review of early rehabilitation in adults during mechanical ventilation reported that early rehabilitation may improve strength, functional recovery at hospital discharge, and days alive and at home in the 6 months after critical illness [57]. Patients receiving ECMO may benefit from less sedation and early rehabilitation, and recent studies found that rehabilitation, including mobilization (Fig.…”

Section: Aq4mentioning

confidence: 99%

The ICM research agenda on extracorporeal life support

et al. 2017

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“…In a recent meta-analysis of active mobilization and rehabilitation during ICU, patients who were randomized to early mobilization and rehabilitation had improved muscle strength and were more likely to be able to walk independently at hospital discharge Fig. 1 The next steps in measuring and improving physical function after ICU compared to patients who received standard care [16]. The meta-analysis showed no difference in health status measured with the SF-36 domain of physical function.…”

mentioning

confidence: 99%