TY - JOUR
T1 - Early Physical Rehabilitation in the ICU
T2 - A Review for the Neurohospitalist
AU - Mendez-Tellez, Pedro A.
AU - Nusr, Rasha
AU - Needham, Dale M.
AU - Feldman, Dorianne
PY - 2012/7
Y1 - 2012/7
N2 - Advances in critical care have resulted in improved intensive care unit (ICU) mortality. However, improved ICU survival has resulted in a growing number of ICU survivors living with long-term sequelae of critical illness, such as impaired physical function and quality of life (QOL). In addition to critical illness, prolonged bed rest and immobility may lead to severe physical deconditioning and loss of muscle mass and muscle weakness. ICU-acquired weakness is associated with increased duration of mechanical ventilation and weaning, longer ICU and hospital stay, and increased mortality. These physical impairments may last for years after ICU discharge. Early Physical Medicine and Rehabilitation (PM&R) interventions in the ICU may attenuate or prevent the weakness and physical impairments occurring during critical illness. This article reviews the evidence regarding safety, feasibility, barriers, and benefits of early PM&R interventions in ICU patients and discusses the limited existing data on early PM&R in the neurological ICU and future directions for early PM&R in the ICU.
AB - Advances in critical care have resulted in improved intensive care unit (ICU) mortality. However, improved ICU survival has resulted in a growing number of ICU survivors living with long-term sequelae of critical illness, such as impaired physical function and quality of life (QOL). In addition to critical illness, prolonged bed rest and immobility may lead to severe physical deconditioning and loss of muscle mass and muscle weakness. ICU-acquired weakness is associated with increased duration of mechanical ventilation and weaning, longer ICU and hospital stay, and increased mortality. These physical impairments may last for years after ICU discharge. Early Physical Medicine and Rehabilitation (PM&R) interventions in the ICU may attenuate or prevent the weakness and physical impairments occurring during critical illness. This article reviews the evidence regarding safety, feasibility, barriers, and benefits of early PM&R interventions in ICU patients and discusses the limited existing data on early PM&R in the neurological ICU and future directions for early PM&R in the ICU.
KW - bed rest
KW - deconditioning
KW - early ICU rehabilitation
KW - early Neuro-ICU rehabilitation
KW - feasibility
KW - immobility
KW - muscle weakness
KW - outcomes
KW - safety
UR - http://www.scopus.com/inward/record.url?scp=84992897700&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84992897700&partnerID=8YFLogxK
U2 - 10.1177/1941874412447631
DO - 10.1177/1941874412447631
M3 - Review article
C2 - 23983871
AN - SCOPUS:84992897700
SN - 1941-8744
VL - 2
SP - 96
EP - 105
JO - The Neurohospitalist
JF - The Neurohospitalist
IS - 3
ER -