Exercise in the ICU Flashcards
What is the ICU?
- Special department of hospital that provides intensive care medicine
What kind of patients are in the ICU?
- Seriously/Critically Ill
- Risk of or recovering from life-threatening conditions
What are some common conditions treated in the ICU?
- Acute respiratory distress syndrome
- Septic Shock
- Other life-threatening conditions
What is common with patients in the ICU?
- Muscle Dysfunction
-peripheral
-respiratory
Why is muscle dysfunction common in patients in the intensive care unit?
- Inactivity
- Inflammation
- Pharmacologic Agents
- Neuromuscular syndromes with critical illness
What might respiratory muscle weakness be at its onset?
- Important factor, leading to prolonged ICU stay
Why might respiratory muscle weakness onset be a factor leading to prolonged ICU stay?
- Weaning failure from mechanical ventilation
How prevalent is peripheral muscle weakness in patients with mechanical ventilation for 4-7 days?
25-33%
How prevalent is peripheral muscle weakness in patients with acute respiratory distress syndrome?
60%
How prevalent is peripheral muscle weakness in patients with septic shock?
35-76%
What is peripheral muscle weakness linked within the ICU?
- Increased Mortality
What does a prolonged ICU stay contribute to?
- Impaired functional status
- Impaired quality of life
How long can a prolonged ICU stay contribute to impaired functional status and quality of life?
- Possibly 1 year after discharge
What is associated with impaired functional status? What is not associated with it?
Is
- Muscle Weakness
Is NOT
- Pulmonary Function
When is muscle wasting the highest during an ICU stay?
- During first 2-3 weeks
What is important for patients with expected prolonged bed rest regarding muscle wasting?
- Important to prevent or attenuate muscle deconditioning as early as possible
What does the European Respiratory Society and Society of Intensive Care Medicine advice regarding critically ill patients?
- Start early with active and passive exercise
What was the rational for the study on early exercise in critically ill patients?
- Prolonged stay in ICU associated with muscle dysfunction
- Muscle dysfunction contributes to impaired functional status up to 1 year after discharge.
What was the objective of the study on early exercise in critically ill patients?
- Investigate whether daily exercise is safe and effective for preventing decrease in functional exercise capacity, functional status, and quadriceps force associated with prolonged ICU stay
What was the design of the study on early exercise in critically ill patients?
- Randomized Controlled Trial
What was the setting of the study on early exercise in critically ill patients?
- Medical/surgical ICU at University Hospital Gasthuisberg
Who were the patients in the study on early exercise in critically ill patients?
- 90 critically ill patients
- Starting day 5 of recovery
- expected prolonged ICU stay
What was the intervention of the study on early exercise in critically ill patients?
Both Groups
- Respiratory physiotherapy
- Standardized passive/active motion session of upper and lower limbs
Treatment Group
- Passive or active exercise training session 20min/day using bedside ergometer bike
Describe the exercise intervention used in the treatment group of the study on early exercise in critically ill patients?
- 5 days a week, 20min/day
- Bedside cycle ergometer
- Divided into two bouts of 10min
- Individually adjusted intensity level
