Effect of multimodality chest physiotherapy in prevention of ventilator-associated pneumonia: A randomized clinical trial
This study was designed to evaluate the effect of multimodality chest physiotherapy in intubated and mechanically ventilated patients undergoing treatment in the intensive care units (ICUs) for prevention of VAP. A total of 101 adult intubated and mechanically ventilated patients were included in this study. Manual hyperinflation (MH) and suctioning were administered to patients in the control group (n = 51), and positioning and… Continue readingAn investigation of the use of passive movements in intensive care by UK physiotherapists.
The purpose of this study was to investigate the current use of passive movements (PMs) by National Health Service (NHS) physiotherapists working with sedated and ventilated patients in critical care settings. DESIGN: Postal questionnaire. SETTING: All open NHS critical/intensive care units in England, Northern Ireland, Scotland and Wales. PARTICIPANTS: Physiotherapists working in UK NHS critical/intensive care units. RESULTS: Questionnaires were posted to 246 physiotherapists working in intensive care units; 165… Continue readingMonitoring of extubated patients: are routine arterial blood gas measurements useful and how long should patients be monitored in the intensive care unit?
The authors aimed to investigate whether serial arterial blood gas measurements done in the post-extubation period would help to identify patients requiring restitution of ventilatory support and to determine the optimal duration of close monitoring post-extubation. One hundred and fifteen adult patients were retrospectively analysed. Arterial blood gases were measured at one and three hours post-extubation and patients were followed for any restitution of respiratory support for the remainder of their hospital stay. Restitution of respiratory… Continue readingLung Opening and Closing during Ventilation of Acute Respiratory Distress Syndrome
This study was desgined to determine how lung recruitability influences alveolar strain and intratidal opening and closing after the application of high PEEP. Data from 68 patients with acute lung injury or acute respiratory distress syndrome (ARDS) who underwent whole-lung computed tomography at 5, 15, and 45 cm H2O airway pressure was analysed. In patients with a higher percentage of potentially recruitable lung, the increase in PEEP markedly reduced opening and closing lung… Continue readingConsequences of bed rest
This article gives an overview of the consequences of bed rest and possible treatment options for reducing these consequences. Brower, RG. CRITICAL CARE MEDICINE 2009; 37 (10): S422 - S428Intensive care unit-acquired weakness: Risk factors and prevention
In this article the authors discuss the risk factors for and the prevention of intensive care unit-acquired weakness. Five main risk factors for intensive care unit-acquired weakness have been identified. These include multiple organ failure, muscle inactivity, hyperglycemia, and use of corticosteroids and neuromuscular blockers. The authors point out that although strong evidence regarding the efficacy of preventive measures is still lacking, the results of available studies are promising and cast doubt on the widespread belief… Continue reading
Measurement of muscle strength in the intensive care unit
This paper explores the measures available to assess and predict intensive care unit-acquired muscle weakness. The discussion centres around the selection of the appropriate muscle to test in order to make adequate predictions of a patient's outcome. The authors propose that the upper airway dilators are much more susceptible to a decrease in muscle strength than the diaphragm, and impairment of upper airway patency is a key mechanism of extubation failure
ICU-Acquired Weakness
Critical Care Medicine has published the proceedings of a round table conference which was held in Brussels, last March. The table of contents consists of articles that will be of interest to those working in critical care situations and includes several articles on early mobilisation. Table of contents:- A framework for diagnosing and classifying intensive care unit-acquired weakness
- Intensive care unit-acquired weakness: Risk factors and prevention
- Use of electrophysiologic testing
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