Study on critical illness rehabilitation_West China Medical Journal

Authors：

YU Jiadan ^1,2,3 , YU Pengming ^1,2 , WEI Qingchuan ^1,2 , JIA Chengsen ^1,2 , XIE Wei ^1,2 , SU Jianhua ^1,2 , YANG Mengxuan ^1,2 , ZHOU Yaxin ^1,2 , LI Lei ^1,2 , JIANG Hua ^1,2 , WANG Jiao ^1,2 ,  HE Chengqi ^1,2

1. Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Rehabilitation Medicine Key Laboratory of Sichuan Province, Chengdu, Sichuan 610041, P. R. China;
3. School of Rehabilitation Sciences, West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

HE Chengqi, Email: hxkfhcq2015@126.com

Keywords：

Critical illness rehabilitation; Critical care medicine; Intensive care unit; Rehabilitation therapy; Review

DOI：

10.7507/1002-0179.201807050

Video：

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With the continuous development of critical care medicine, the survival rate of critical ill patients continues to increase. However, the residual dysfunction will have a far-reaching impact on the burden on patients, families, and health-care systems, and will significantly increase the demand of the follow-up rehabilitation treatment. Critical illness rehabilitation intervenes patients who are still in the intensive care unit (ICU). It can prevent complications, functional deterioration and dysfunction, improve functional activity and quality of life, shorten the time of mechanical ventilation, the length of ICU stay and hospital stay, and also reduce medical expenses. Experts at home and abroad believe that early rehabilitation of critical ill patients is safe and effective. So rehabilitation should be involved in critical ill patients as early as possible. However, the promotion of this model is still limited by the setting of safety parameters, the ICU culture, the lack of critical rehabilitation professionals, and the physiological and mental cognitive status of patients. Rehabilitation treatment in ICU is constantly being practiced at home and abroad.

Citation： YU Jiadan, YU Pengming, WEI Qingchuan, JIA Chengsen, XIE Wei, SU Jianhua, YANG Mengxuan, ZHOU Yaxin, LI Lei, JIANG Hua, WANG Jiao, HE Chengqi. Study on critical illness rehabilitation. West China Medical Journal, 2018, 33(10): 1207-1212. doi: 10.7507/1002-0179.201807050 Copy

1.	Farhan H, Moreno-Duarte I, Latronico N, et al. Acquired muscle weakness in the surgical intensive care unit: nosology, epidemiology, diagnosis, and prevention. Anesthesiology, 2016, 124(1): 207-234.
2.	Hermans G, Van den Berghe G. Clinical review: intensive care unit acquired weakness. Crit Care, 2015, 19: 274.
3.	Friedrich O, Reid MB, Van den Berghe G, et al. The sick and the weak: neuropathies/myopathies in the critically ill. Physiol Rev, 2015, 95(3): 1025-1109.
4.	Angus DC, Clermont G, Linde-Zwirble WT, et al. Healthcare costs and long-term outcomes after acute respiratory distress syndrome: a phase Ⅲ trial of inhaled nitric oxide. Crit Care Med, 2006, 34(12): 2883-2890.
5.	van der Schaaf M, Beelen A, Dongelmans DA, et al. Poor functional recovery after a critical illness: a longitudinal study. J Rehabil Med, 2009, 41(13): 1041-1048.
6.	Needham DM, Feldman DR, Kho ME. The functional costs of ICU survivorship. Collaborating to improve post-ICU disability. Am J Respir Crit Care Med, 2011, 183(8): 962-964.
7.	van der Schaaf M, Beelen A, Dongelmans DA, et al. Functional status after intensive care: a challenge for rehabilitation professionals to improve outcome. J Rehabil Med, 2009, 41(5): 360-366.
8.	李建华, 许志生, 边仁秀, 等. 重症监护病房的康复医学治疗进展. 中国康复医学杂志, 2011, 26(11): 1084-1087.
9.	Tan T, Brett SJ, Stokes T, et al. Rehabilitation after critical illness: summary of NICE guidance. BMJ, 2009, 338(338): b822.
10.	World Health Organization. The international classification of functioning, disability and health. Geneva: World Health Organization, 2001.
11.	Ward AB, Gutenbrunner C, Damjan H, et al. European union of medical specialist section of physical & rehabilitation medicine: a position paper on physical and rehabilitation medicine in acute setting. J Rehabil Med, 2010, 42(5): 417-424.
12.	Mendez-Tellez PA, Nusr R, Feldman D, et al. Early physical rehabilitation in the ICU: a review for the neurohospitalist. Neurohospitalist, 2012, 2(3): 96-105.
13.	Schweickert WD, Pohlman MC, Pohlman AS, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet, 2009, 373(9678): 1874-1882.
14.	Li ZQ, Peng XX, Zhu B, et al. Active mobilization for mechanically ventilated patients: a systematic review. Arch Phys Med Rehabil, 2013, 94(3): 551-561.
15.	Bolton CF. The discovery of critical illness polyneuropathy: a memoir. Can J Neurol Sci, 2010, 37(4): 431-438.
16.	Latronico N, Bolton CF. Critical illness polyneuropathy and myopathy: a major cause of muscle weakness and paralysis. Lancet Neurol, 2011, 10(10): 931-941.
17.	Stevens RD, Marshall SA, Cornblath DR, et al. A framework for diagnosing and classifying intensive care unit-acquired weakness. Crit Care Med, 2009, 37(10 Suppl): S299-S308.
18.	Salluh JI, Soares M, Teles JM, et al. Delirium epidemiology in critical care (DECCA): an international study. Crit Care, 2010, 14(6): R210-R217.
19.	Wilcox ME, Brummel NE, Archer K, et al. Cognitive dysfunction in ICU patients: risk factors, predictors, and rehabilitation interventions. Crit Care Med, 2013, 41(9 Suppl 1): S81-S98.
20.	Griffiths J, Hatch RA, Bishop J, et al. An exploration of social and economic outcome and associated health-related quality of life after critical illness in general intensive care unit survivors: a 12-month follow-up study. Crit Care, 2013, 17(3): R100.
21.	Hodgson CL, Stiller K, Needham DM, et al. Expert consensus and recommendations on safety criteria for active mobilization of mechanically ventilated critically ill adults. Crit Care, 2014, 18(6): 658.
22.	Schaller SJ, Anstey M, Blobner M, et al. Early, goal-directed mobilisation in the surgical intensive care unit: a randomised controlled trial. Lancet, 2016, 388(152): 1377-1388.
23.	Balas MC, Burke WJ, Gannon D, et al. Implementing the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle into everyday care: opportunities, challenges, and lessons learned for implementing the ICU Pain, Agitation, and Delirium Guidelines. Crit Care Med, 2013, 41(9 Suppl 1): S116-S127.
24.	Vasilevskis EE, Ely EW, Speroff T, et al. Reducing iatrogenic risks ICU-acquired delirium and weakness-crossing the quality chasm. Chest, 2010, 138(5): 1224-1233.
25.	Bailey P, Thomsen GE, Spuhler VJ, et al. Early activity is feasible and safe in respiratory failure patients. Crit Care Med, 2007, 35(1): 139-145.
26.	Berney S, Haines K, Skinner EH, et al. Safety and feasibility of an exercise prescription approach to rehabilitation across the continuum of care for survivors of critical illness. Phys Ther, 2012, 92(12): 1524-1535.
27.	Pohlman MC, Schweickert WD, Pohlman AS, et al. Feasibility of physical and occupational therapy beginning from initiation of mechanical ventilation. Crit Care Med, 2010, 38(11): 2089-2094.
28.	Sricharoenchai T, Parker AM, Zanni JM, et al. Safety of physical therapy interventions in critically ill patients: a single-center prospective evaluation of 1110 intensive care unit admissions. J Crit Care, 2014, 29(3): 395-400.
29.	Zafiropoulos B, Alison JA, Mccarren B. Physiological responses to the early mobilisation of the intubated, ventilated abdominal surgery patient. Aust J Physiother, 2004, 50(2): 95-100.
30.	Zanni JM, Korupolu R, Fan E, et al. Rehabilitation therapy and outcomes in acute respiratory failure: an observational pilot project. J Crit Care, 2010, 25(2): 254-262.
31.	Sommers J, Engelbert RH, Dettling-Ihnenfeldt D, et al. Physiotherapy in the intensive care unit: an evidence-based, expert driven, practical statement and rehabilitation recommendations. Clin Rehabil, 2015, 29(11): 1051-1063.
32.	Hanekom S, Gosselink R, Dean E, et al. The development of a clinical management algorithm for early physical activity and mobilization of critically ill patients: synthesis of evidence and expert opinion and its translation into practice. Clin Rehabil, 2011, 25(9): 771-787.
33.	Morris PE, Goad A, Thompson C, et al. Early intensive care unit mobility therapy in the treatment of acute respiratory failure. Crit Care Med, 2008, 36(8): 2238-2243.
34.	Burtin C, Clerckx B, Robbeets CA, et al. Early exercise in critically ill patients enhances short-term functional recovery. Crit Care Med, 2009, 37(9): 2499-2505.
35.	Routsi C, Gerovasili V, Vasileiadis I, et al. Electrical muscle stimulation prevents critical illness polyneuromyopathy: a randomized parallel intervention trial. Crit Care, 2010, 14(2): R74.
36.	Denehy L, Skinner EH, Edbrooke L, et al. Exercise rehabilitation for patients with critical illness: a randomized controlled trial with 12 months of follow-up. Crit Care, 2013, 17(4): R156.
37.	Moss M, Nordon-Craft A, Malone D, et al. A randomized trial of an intensive physical therapy program for patients with acute respiratory failure. Am J Respir Crit Care Med, 2016, 193(10): 1101-1110.
38.	De Jonghe B, Cook D, Sharshar T, et al. Acquired neuromuscular disorders in critically ill patients: a systematic review. Groupe de Reflexion et d’Etude sur les Neuromyopathies En Reanimation. Intensive Care Med, 1998, 24(12): 1242-1250.
39.	Hermans G, De Jonghe B, Bruyninckx F, et al. Interventions for preventing critical illness polyneuropathy and critical illness myopathy. Cochrane Database Syst Rev, 2009(1): CD006832.
40.	Stevens RD, Dowdy DW, Michaels RK, et al. Neuromuscular dysfunction acquired in critical illness: a systematic review. Intensive Care Med, 2007, 33(11): 1876-1891.
41.	Calvo-Ayala E, Khan BA, Farber MO, et al. Interventions to improve the physical function of ICU survivors: a systematic review. Chest, 2013, 144(5): 1469-1480.
42.	Kress JP, Pohlman AS, O’connor MF, et al. Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med, 2000, 342(20): 1471-1477.
43.	Barr J, Fraser GL, Puntillo K, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med, 2013, 41(1): 263-306.
44.	Girard TD, Kress JP, Fuchs BD, et al. Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (Awakening and Breathing Controlled trial): a randomised controlled trial. Lancet, 2008, 371(967): 126-134.
45.	Bakhru RN, Wiebe DJ, Mcwilliams DJ, et al. An environmental scan for early mobilization practices in U.S. ICUs. Crit Care Med, 2015, 43(11): 2360-2369.
46.	Leditschke IA, Green M, Irvine J, et al. What are the barriers to mobilizing intensive care patients?. Cardiopulm Phys Ther J, 2012, 23(1): 26-29.
47.	Needham DM, Korupolu R, Zanni JM, et al. Early physical medicine and rehabilitation for patients with acute respiratory failure: a quality improvement project. Arch Phys Med Rehabil, 2010, 91(4): 536-542.
48.	Balas MC, Vasilevskis EE, Olsen KM, et al. Effectiveness and safety of the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle. Crit Care Med, 2014, 42(5): 1024-1036.
49.	Deng H, Chen J, Li F, et al. Effects of mobility training on severe burn patients in the BICU: A retrospective cohort study. Burns, 2016, 42(7): 1404-1412.

1. Farhan H, Moreno-Duarte I, Latronico N, et al. Acquired muscle weakness in the surgical intensive care unit: nosology, epidemiology, diagnosis, and prevention. Anesthesiology, 2016, 124(1): 207-234.
2. Hermans G, Van den Berghe G. Clinical review: intensive care unit acquired weakness. Crit Care, 2015, 19: 274.
3. Friedrich O, Reid MB, Van den Berghe G, et al. The sick and the weak: neuropathies/myopathies in the critically ill. Physiol Rev, 2015, 95(3): 1025-1109.
4. Angus DC, Clermont G, Linde-Zwirble WT, et al. Healthcare costs and long-term outcomes after acute respiratory distress syndrome: a phase Ⅲ trial of inhaled nitric oxide. Crit Care Med, 2006, 34(12): 2883-2890.
5. van der Schaaf M, Beelen A, Dongelmans DA, et al. Poor functional recovery after a critical illness: a longitudinal study. J Rehabil Med, 2009, 41(13): 1041-1048.
6. Needham DM, Feldman DR, Kho ME. The functional costs of ICU survivorship. Collaborating to improve post-ICU disability. Am J Respir Crit Care Med, 2011, 183(8): 962-964.
7. van der Schaaf M, Beelen A, Dongelmans DA, et al. Functional status after intensive care: a challenge for rehabilitation professionals to improve outcome. J Rehabil Med, 2009, 41(5): 360-366.
8. 李建华, 许志生, 边仁秀, 等. 重症监护病房的康复医学治疗进展. 中国康复医学杂志, 2011, 26(11): 1084-1087.
9. Tan T, Brett SJ, Stokes T, et al. Rehabilitation after critical illness: summary of NICE guidance. BMJ, 2009, 338(338): b822.
10. World Health Organization. The international classification of functioning, disability and health. Geneva: World Health Organization, 2001.
11. Ward AB, Gutenbrunner C, Damjan H, et al. European union of medical specialist section of physical & rehabilitation medicine: a position paper on physical and rehabilitation medicine in acute setting. J Rehabil Med, 2010, 42(5): 417-424.
12. Mendez-Tellez PA, Nusr R, Feldman D, et al. Early physical rehabilitation in the ICU: a review for the neurohospitalist. Neurohospitalist, 2012, 2(3): 96-105.
13. Schweickert WD, Pohlman MC, Pohlman AS, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet, 2009, 373(9678): 1874-1882.
14. Li ZQ, Peng XX, Zhu B, et al. Active mobilization for mechanically ventilated patients: a systematic review. Arch Phys Med Rehabil, 2013, 94(3): 551-561.
15. Bolton CF. The discovery of critical illness polyneuropathy: a memoir. Can J Neurol Sci, 2010, 37(4): 431-438.
16. Latronico N, Bolton CF. Critical illness polyneuropathy and myopathy: a major cause of muscle weakness and paralysis. Lancet Neurol, 2011, 10(10): 931-941.
17. Stevens RD, Marshall SA, Cornblath DR, et al. A framework for diagnosing and classifying intensive care unit-acquired weakness. Crit Care Med, 2009, 37(10 Suppl): S299-S308.
18. Salluh JI, Soares M, Teles JM, et al. Delirium epidemiology in critical care (DECCA): an international study. Crit Care, 2010, 14(6): R210-R217.
19. Wilcox ME, Brummel NE, Archer K, et al. Cognitive dysfunction in ICU patients: risk factors, predictors, and rehabilitation interventions. Crit Care Med, 2013, 41(9 Suppl 1): S81-S98.
20. Griffiths J, Hatch RA, Bishop J, et al. An exploration of social and economic outcome and associated health-related quality of life after critical illness in general intensive care unit survivors: a 12-month follow-up study. Crit Care, 2013, 17(3): R100.
21. Hodgson CL, Stiller K, Needham DM, et al. Expert consensus and recommendations on safety criteria for active mobilization of mechanically ventilated critically ill adults. Crit Care, 2014, 18(6): 658.
22. Schaller SJ, Anstey M, Blobner M, et al. Early, goal-directed mobilisation in the surgical intensive care unit: a randomised controlled trial. Lancet, 2016, 388(152): 1377-1388.
23. Balas MC, Burke WJ, Gannon D, et al. Implementing the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle into everyday care: opportunities, challenges, and lessons learned for implementing the ICU Pain, Agitation, and Delirium Guidelines. Crit Care Med, 2013, 41(9 Suppl 1): S116-S127.
24. Vasilevskis EE, Ely EW, Speroff T, et al. Reducing iatrogenic risks ICU-acquired delirium and weakness-crossing the quality chasm. Chest, 2010, 138(5): 1224-1233.
25. Bailey P, Thomsen GE, Spuhler VJ, et al. Early activity is feasible and safe in respiratory failure patients. Crit Care Med, 2007, 35(1): 139-145.
26. Berney S, Haines K, Skinner EH, et al. Safety and feasibility of an exercise prescription approach to rehabilitation across the continuum of care for survivors of critical illness. Phys Ther, 2012, 92(12): 1524-1535.
27. Pohlman MC, Schweickert WD, Pohlman AS, et al. Feasibility of physical and occupational therapy beginning from initiation of mechanical ventilation. Crit Care Med, 2010, 38(11): 2089-2094.
28. Sricharoenchai T, Parker AM, Zanni JM, et al. Safety of physical therapy interventions in critically ill patients: a single-center prospective evaluation of 1110 intensive care unit admissions. J Crit Care, 2014, 29(3): 395-400.
29. Zafiropoulos B, Alison JA, Mccarren B. Physiological responses to the early mobilisation of the intubated, ventilated abdominal surgery patient. Aust J Physiother, 2004, 50(2): 95-100.
30. Zanni JM, Korupolu R, Fan E, et al. Rehabilitation therapy and outcomes in acute respiratory failure: an observational pilot project. J Crit Care, 2010, 25(2): 254-262.
31. Sommers J, Engelbert RH, Dettling-Ihnenfeldt D, et al. Physiotherapy in the intensive care unit: an evidence-based, expert driven, practical statement and rehabilitation recommendations. Clin Rehabil, 2015, 29(11): 1051-1063.
32. Hanekom S, Gosselink R, Dean E, et al. The development of a clinical management algorithm for early physical activity and mobilization of critically ill patients: synthesis of evidence and expert opinion and its translation into practice. Clin Rehabil, 2011, 25(9): 771-787.
33. Morris PE, Goad A, Thompson C, et al. Early intensive care unit mobility therapy in the treatment of acute respiratory failure. Crit Care Med, 2008, 36(8): 2238-2243.
34. Burtin C, Clerckx B, Robbeets CA, et al. Early exercise in critically ill patients enhances short-term functional recovery. Crit Care Med, 2009, 37(9): 2499-2505.
35. Routsi C, Gerovasili V, Vasileiadis I, et al. Electrical muscle stimulation prevents critical illness polyneuromyopathy: a randomized parallel intervention trial. Crit Care, 2010, 14(2): R74.
36. Denehy L, Skinner EH, Edbrooke L, et al. Exercise rehabilitation for patients with critical illness: a randomized controlled trial with 12 months of follow-up. Crit Care, 2013, 17(4): R156.
37. Moss M, Nordon-Craft A, Malone D, et al. A randomized trial of an intensive physical therapy program for patients with acute respiratory failure. Am J Respir Crit Care Med, 2016, 193(10): 1101-1110.
38. De Jonghe B, Cook D, Sharshar T, et al. Acquired neuromuscular disorders in critically ill patients: a systematic review. Groupe de Reflexion et d’Etude sur les Neuromyopathies En Reanimation. Intensive Care Med, 1998, 24(12): 1242-1250.
39. Hermans G, De Jonghe B, Bruyninckx F, et al. Interventions for preventing critical illness polyneuropathy and critical illness myopathy. Cochrane Database Syst Rev, 2009(1): CD006832.
40. Stevens RD, Dowdy DW, Michaels RK, et al. Neuromuscular dysfunction acquired in critical illness: a systematic review. Intensive Care Med, 2007, 33(11): 1876-1891.
41. Calvo-Ayala E, Khan BA, Farber MO, et al. Interventions to improve the physical function of ICU survivors: a systematic review. Chest, 2013, 144(5): 1469-1480.
42. Kress JP, Pohlman AS, O’connor MF, et al. Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med, 2000, 342(20): 1471-1477.
43. Barr J, Fraser GL, Puntillo K, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med, 2013, 41(1): 263-306.
44. Girard TD, Kress JP, Fuchs BD, et al. Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (Awakening and Breathing Controlled trial): a randomised controlled trial. Lancet, 2008, 371(967): 126-134.
45. Bakhru RN, Wiebe DJ, Mcwilliams DJ, et al. An environmental scan for early mobilization practices in U.S. ICUs. Crit Care Med, 2015, 43(11): 2360-2369.
46. Leditschke IA, Green M, Irvine J, et al. What are the barriers to mobilizing intensive care patients?. Cardiopulm Phys Ther J, 2012, 23(1): 26-29.
47. Needham DM, Korupolu R, Zanni JM, et al. Early physical medicine and rehabilitation for patients with acute respiratory failure: a quality improvement project. Arch Phys Med Rehabil, 2010, 91(4): 536-542.
48. Balas MC, Vasilevskis EE, Olsen KM, et al. Effectiveness and safety of the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle. Crit Care Med, 2014, 42(5): 1024-1036.
49. Deng H, Chen J, Li F, et al. Effects of mobility training on severe burn patients in the BICU: A retrospective cohort study. Burns, 2016, 42(7): 1404-1412.

West China Medical Journal

Study on critical illness rehabilitation

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