Use of the Functional Independence Measure in People for Whom Weaning From Mechanical Ventilation Is Difficult

Abstract

The FIM can be used as a functional status outcome measure in people for whom weaning from mechanical ventilation is difficult.

Effects of a Multidisciplinary Care Program on Disability, Autonomy, and Nursing Needs in Subjects Recovering From Acute Respiratory Failure in a Chronic Ventilator Facility

“…20 Clini et al 21 showed that most PMV subjects can benefit from a comprehensive rehabilitation program, suggesting that the degree of improvement of functional disability is associated with survival and weaning success rates. Using the Functional Independence Measure scale as a good indicator of neuromotor disability improvement, Montagnani et al 23 confirmed the positive effects of rehabilitation on functional status in subjects for whom weaning from mechanical ventilation is difficult.…”

“…3,11,12 In particular, patients may receive a prompt and dedicated physiotherapy rehabilitation program in chronic ventilator facilities, 1,3,13 and transfer from an ICU to a chronic ventilator facility substantially improved patients' ambulation and activities of daily life irrespective of the underlying pathophysiology, avoiding unnecessary immobilization 14 . To date, the role of comprehensive rehabilitation in critically ill adults still remains controversial 13 or not fully established 15 : patients who have survived a recent acute respiratory failure (ARF) event can benefit from an individually tailored physiotherapy rehabilitation program that improves clinical indices, respiratory and peripheral muscle strength, activities of daily life, exercise tolerance, and disability scores. 14,[16][17][18][19][20][21][22][23][24] Once the precipitating cause of the ARF episode has been solved, these chronically ill patients still require care due to their huge motor disabilities, clinical dependence (oxygen, mechanical ventilation, nutritional, and communication device needs), and nursing necessities, 3 which the care team (physiotherapist, doctor, and nurse) must measure to better guide the daily care of the patient. No study has been performed with a large patient sample to investigate patient needs with these 3 different perspectives combined.…”

Funcionalidade E Complicações Em Pacientes Gravemente Enfermos Reinternados No Hospital

“…Pacientes com longo tempo de internação na UTI em ventilação mecânica invasiva prolongada estão sujeitos a maior perda de massa muscular e óssea, com recuperação funcional mais demorada em relação aos que apresentam tempo de internação mais curto. Além disso, as situações que o paciente enfrenta como o medo da morte, separação da família, ambiente desconhecido, procedimentos invasivos e alterações funcionais, colaboram para aumentar o estado de estresse, traumas, tensão e o tempo de internação hospitalar (7,(10)(11) . Nos últimos anos, há crescente preocupação em relação ao estado no qual o paciente recebe alta da UTI, já não sendo suficiente apenas garantir a sobrevivência, mas também atentar-se para sequelas funcionais.…”

Rehabilitation Considerations for Children Dependent on Long-Term Mechanical Ventilation

“…In another study of 30 infants and children with varying diagnoses but who required oxygen and/or ventilator support upon admission to an inpatient pulmonary rehabilitation program, admission and discharge scores were noted to be on the lower half of the self-care continuum, indicating deficits in self-care function, despite increases in scores from admission to discharge [51]. The Functional Independence measure has been shown useful for detecting changes in function from admission to discharge for adults in pulmonary rehabilitation programs [72].…”