scholarly journals Early Mobilization on Patients with Mechanical Ventilation in the ICU

2020 ◽  
Author(s):  
Tsung-Hsien Wang
Keyword(s):  
Mechanical Ventilation ◽  
Early Mobilization

scholarly journals Early Mobilization: Changing the Mindset

2015 ◽  
Vol 35 (4) ◽  
pp. e1-e6 ◽  
Author(s):  
Emily Castro ◽  
Michael Turcinovic ◽  
John Platz ◽  
Isabel Law
Keyword(s):  
Mechanical Ventilation ◽  
Interdisciplinary Collaboration ◽  
Early Mobilization ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Team Collaboration ◽  
Vein Thrombosis ◽  
Implementation Evaluation ◽  
Skin Breakdown ◽  
Deep Vein

BACKGROUND Staff in the surgical intensive care unit (SICU) had several concerns about mobilizing patients receiving mechanical ventilation. OBJECTIVE To assess and improve the mindset of SICU staff toward early mobilization of patients receiving mechanical ventilation before, 6 months after, and 1 year after implementation of early mobilization. METHODS The Plan-Do-Study-Act model was used to guide the planning, implementation, evaluation, and interventions to change the mindset and practice of SICU staff in mobilizing patients receiving mechanical ventilation. Interventions to overcome barriers to early mobilization included interdisciplinary collaboration, multimodal education, and operational changes. The mindset of the SICU staff toward early mobilization of patients receiving mechanical ventilation was assessed by using a survey questionnaire distributed 2 weeks before, 6 months after, and 1 year after implementation of early mobilization. RESULTS The median score on 6 of 7 survey questions changed significantly from before, to 6 months after, to 1 year after implementation, indicating a change in the mindset of SICU staff toward early mobilization of patients receiving mechanical ventilation. The SICU staff agreed that most patients receiving mechanical ventilation are able to get out of bed safely with coordination among personnel and that early mobilization of intubated patients decreases length of stay and decreases occurrence of ventilator-associated pneumonia, deep vein thrombosis, and skin breakdown. CONCLUSIONS SICU interdisciplinary team collaboration, multimodal education, and operational support contribute to removing staff bias against mobilizing patients receiving mechanical ventilation.

scholarly journals CONOCIMIENTOS, PERCEPCIONES Y PRÁCTICAS EN PROFESIONALES DE LA SALUD SOBRE MOVILIZACION TEMPRANA EN LOS PACIENTES DE LAS UNIDADES DE CUIDADOS INTENSIVOS

2021 ◽  
Vol 6 (2) ◽  
pp. 5
Author(s):  
Ángela Yaleska Arévalo Tabares ◽  
Freiser Eceomo Cruz Mosquera ◽  
Yuly Viviana Valencia Salazar ◽  
Diego Alonzo Peláez Domínguez ◽  
Juan David Rosero Portocarrero
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Health Professionals ◽  
Early Mobilization ◽  
Post Discharge ◽  
Cross Sectional ◽  
Usual Practice ◽  
Calidad De Vida ◽  
Critical Patients

Introducción: Los pacientes críticos son sometidos a intervenciones que traen consigo complicaciones que pueden aparecer incluso de manera precoz, entre ellas se encuentra la debilidad muscular adquirida en unidad de cuidados intensivos, en este contexto tiene una importancia fundamental la movilización temprana del paciente crítico, que facilita el destete de la ventilación mecánica e influye en la calidad de vida posterior al alta. Objetivo: determinar los conocimientos, percepciones y prácticas en profesionales de la salud sobre movilizacion temprana en los pacientes de las unidades de cuidados intensivos de dos centros de salud de Cali.  Método: estudio observacional descriptivo de corte transversal en el que se incluyeron 24 profesionales de la salud que laboran en unidades de cuidados intensivos de dos Clínicas de la Ciudad de Cali, a los cuales se les aplicó un cuestionario autoadministrado sobre movilización temprana. El análisis de los datos se realizó en el programa SPSS versión 24. Resultados: La mayoría de los profesionales de la salud encuestados eran de sexo femenino, con una edad promedio de 31±5; se encontró que el 67% tenía un conocimiento medio, el 25% bajo y el 8% conocimiento alto. Por otro lado, el 88% manifestó ejecutar esta estrategia en su práctica habitual, y reportaron como barreras percibidas ausencia de protocolos y personal insuficiente. Conclusiones: gran parte de los profesionales de salud encuestados mostraron un conocimiento medio sobre movilización temprana y una alta incorporación de esta estrategia a la práctica clínica habitual. Palabras claves: movilización precoz de paciente crítico, cuidados intensivos, paciente crítico, ventilación mecánica. ABSTRACT Introduction: Critical patients are subjected to interventions that bring complications that can appear even early, among them is muscle weakness acquired in the intensive care unit, in this context, early mobilization of the critical patient is of fundamental importance, which facilitates weaning from mechanical ventilation and influences post-discharge quality of life. Objective: to determine the knowledge, perceptions and practices in health professionals about early mobilization in patients in the intensive care units of two health centers in Cali. Method: a descriptive, cross-sectional observational study that included 24 health professionals working in intensive care units of two Clinics in the City of Cali, to which a self-administered questionnaire on early mobilization was applied. Data analysis was performed using SPSS version 24. Results: Most of the health professionals surveyed were female, with a mean age of 31 ± 5; It was found that 67% had medium knowledge, 25% low and 8% high knowledge. On the other hand, 88% stated that they executed this strategy in their usual practice, and reported the absence of protocols and insufficient personnel as perceived barriers. Conclusions: a large part of the health professionals surveyed showed a medium knowledge about early mobilization and a high incorporation of this strategy into routine clinical practice. Keywords: early mobilization of critical patients, intensive care, critical patients, mechanical ventilation

scholarly journals Physiotherapy approach after lung transplantation in a critically ill COVID-19 patient: a case report

2021 ◽  
Author(s):  
Veronica Rossi ◽  
Serena Tammaro ◽  
Martina Santambrogio ◽  
Mariangela Retucci ◽  
Francesca Gallo ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Lung Transplantation ◽  
Early Mobilization ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Bilateral Lung Transplantation ◽  
Non Invasive Ventilation ◽  
Respiratory Parameters ◽  
Bilateral Lung

This study describes the case of an 18-years-old male affected by severe COVID-19, who was receiving bilateral lung transplantation (LT), after 71 days of mechanical ventilation and 55 days of veno-venous extracorporeal membrane oxygenation. From post-operative day 2, early mobilization and physiotherapy treatments were performed. Weaning from mechanical ventilation, the use of non-invasive ventilation and tracheostomy management were included in the treatment. Forty-five days after LT the patient was discharged at home, showing improvements in terms of functional and respiratory parameters, quality of life and mood. While evidences about physiotherapy treatments in lung transplantation post severe COVID-19 remain limited, early approach and a multidisciplinary team may be considered key elements for functional recovery of these subjects.

Sedatives and anti-anxiety agents in critical illness

2016 ◽  
Author(s):  
Curtis N. Sessler ◽  
Katie M. Muzevich
Keyword(s):  
Mechanical Ventilation ◽  
Early Mobilization ◽  
Patient Characteristics ◽  
Initial Therapy ◽  
Mechanically Ventilated ◽  
Icu Length Of Stay ◽  
Level Of Consciousness ◽  
Continuous Drug Delivery ◽  
Spontaneous Breathing Trials ◽  
Light Sedation

Sedative and anti-anxiety agents are administered to many mechanically-ventilated intensive care unit (ICU) patients. While commonly considered supportive care, suboptimal administration of sedatives has been linked to longer duration of mechanical ventilation and longer ICU length of stay. The use of a structured multidisciplinary approach can help improve outcomes. The level of consciousness, as well as the presence and severity of agitation should be routinely evaluated using a validated sedation–agitation scale. The approach to delivery of sedation should be based upon specific goals, particularly mechanical ventilation, while maintaining the lightest possible level of sedation. Selection should be based upon clinical circumstances and patient characteristics, however, when continuous infusion sedation is required, experts suggest using non-benzodiazepine agents. A variety of strategies for sedation management have been demonstrated to be effective in clinical trials including use of protocols, targeting light sedation, preference of analgesics for initial therapy, use of intermittent, rather than continuous drug delivery when possible, and daily interruption of sedation. Finally, light sedation should be linked to performance of spontaneous breathing trials, as well as early mobilization.

scholarly journals The Effects of Early Mobilization on Patients Requiring Extended Mechanical Ventilation Across Multiple ICUs

2020 ◽  
Vol 2 (6) ◽  
pp. e0119
Author(s):  
Miguel X. Escalon ◽  
Ann H. Lichtenstein ◽  
Elliot Posner ◽  
Lisa Spielman ◽  
Andrew Delgado ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Early Mobilization

scholarly journals Relationship between Ventilator-Associated Events and Timing of Rehabilitation in Subjects with Emergency Tracheal Intubation at Early Mobilization Facility

2018 ◽  
Vol 15 (12) ◽  
pp. 2892 ◽  
Author(s):  
Taku Shinoda ◽  
Hiromasa Nishihara ◽  
Takayuki Shimogai ◽  
Tsubasa Ito ◽  
Ryuya Takimoto ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Tracheal Intubation ◽  
High Mortality ◽  
Early Mobilization ◽  
Positive End Expiratory Pressure ◽  
Rehabilitation Intervention ◽  
Oxygen Fraction ◽  
The Relationship ◽  
Inspired Oxygen

The present study aimed to investigate the relationship between the occurrence of ventilator-associated events (VAE) in the intensive care unit and the timing of rehabilitation intervention. We included subjects who underwent emergency tracheal intubation and received rehabilitation. We performed rehabilitation according to our hospital’s protocol. We assessed the mechanical ventilation parameters of inspired oxygen fraction and positive-end expiratory pressure, and a VAE was identified if these parameters stabilized or decreased for ≥2 days and then had to be increased for ≥2 days. We defined time in hours from tracheal intubation to the first rehabilitation intervention as Timing 1 and that to first sitting on the edge of the bed as Timing 2. Data were analyzed by the t-test and χ2 tests. We finally analyzed 294 subjects. VAE occurred in 9.9% and high mortality at 48.3%. Median values of Timing 1 and Timing 2 in the non-VAE and VAE groups were 30.3 ± 24.0 and 30.0 ± 20.7 h, and 125.7 ± 136.6 and 127.9 ± 111.4 h, respectively, and the differences were not significant (p = 0.95 and p = 0.93, respectively). We found no significant relationship between the occurrence of VAE leading to high mortality and timing of rehabilitation intervention.

scholarly journals Movilización Temprana Como Prevención Y Tratamiento Para La Debilidad Adquirida En La Unidad De Cuidados Intensivos En Pacientes En Ventilación Mecánica. Experiencia En Un Hospital De Segundo Nivel

2018 ◽  
Vol 14 (21) ◽  
pp. 19 ◽  
Author(s):  
Andrea Asenet Calixto Mejía ◽  
Nancy Guadalupe Mendoza Martínez ◽  
Orlando Rubén Pérez Nieto ◽  
Miguel Ángel Martínez Camacho ◽  
Ernesto Deloya Tomas ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Muscle Strength ◽  
Muscular Strength ◽  
Early Mobilization ◽  
Descriptive Study ◽  
Wilcoxon Test ◽  
Partial Recovery ◽  
Convenience Sample ◽  
Significant Difference ◽  
Critical Patients

Introduction: The weakness acquired in the UCI is a condition that appears often in the critical patient, causing deficiencies in their physical and functional state. The early mobilization has proved to be safe and feasible demonstrating an improvement in the muscular strength and functionality of the patient during his stay in the ICU. Objectives: To describe the benefit of early mobilization in relation to muscle strength and functionality of critical patients upon discharge from the ICU. Material and methods: A retrospective, observational and descriptive study was conducted in the period from June to December of 2017, with a convenience sample of patients admitted to the ICU who were under mechanical ventilation and sedation, registration was obtained in the clinical files of muscle strength, functionality and mobility after the withdrawal of sedation and previous discharge of the patient, and the changes found were recorded. Results: A sample of 8 patients was obtained, of which 25% of the patients met the criterion of weakness acquired in the ICU, in the IB it was observed that 100% of the patients obtained a severe dependency with a score between 21 -60 points and the IMS showed that 100% of the patients performed mobilization out of bed with or without assistance. A statistically significant difference was obtained with the Wilcoxon test: MRC (p = 0.012) and IB (p = 0.012). Conclusion: An early mobilization intervention favors the partial recovery of the complications of the stay in the ICU.

Sign in / Sign up

Export Citation Format

Share Document