Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Domain 5 Practical Procedures
- Section 6 Perioperative Care
- Section 7 Comfort and Recovery
- Post-intensive Care Syndrome
- Prevention of Physical and Psychosocial Consequences Following Critical Care Admission
- Structured Rehabilitation Plans
- Long-Term Follow-Up
- Cost Implications
- Introduction
- Importance of Pain Management
- Pain Aetiology in the ICU
- Assessment of Pain in the ICU
- Management
- Procedural Pain
- Sedation
- Neuromuscular Blockade
- Assessment of ICU-AW
- Prevention and Rehabilitation of ICU-AW
- The ABCDEF Bundle
- Rehabilitation after Critical Illness
- Conclusion
- Introduction
- What is Meant by Recovery after Critical Illness?
- Models of Follow-Up Care
- Follow-Up Clinic Consultation
- Follow-Up Clinic Interventions
- Future Directions
- 7.1 How to Identify and Attempt to Minimise the Physical and Psychosocial Consequences of Critical Illness for Patients and Families?
- 7.2 Principles of Assessment, Prevention and Treatment of Pain in Intensive Care
- 7.3 Sedation and Neuromuscular Blockade in Intensive Care
- 7.4 Intensive Care Unit-Acquired Weakness and Physical Rehabilitation
- 7.5 Follow-Up after Critical Illness
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Index
- References
7.4 - Intensive Care Unit-Acquired Weakness and Physical Rehabilitation
from Section 7 - Comfort and Recovery
Published online by Cambridge University Press: 27 July 2023
Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Domain 5 Practical Procedures
- Section 6 Perioperative Care
- Section 7 Comfort and Recovery
- Post-intensive Care Syndrome
- Prevention of Physical and Psychosocial Consequences Following Critical Care Admission
- Structured Rehabilitation Plans
- Long-Term Follow-Up
- Cost Implications
- Introduction
- Importance of Pain Management
- Pain Aetiology in the ICU
- Assessment of Pain in the ICU
- Management
- Procedural Pain
- Sedation
- Neuromuscular Blockade
- Assessment of ICU-AW
- Prevention and Rehabilitation of ICU-AW
- The ABCDEF Bundle
- Rehabilitation after Critical Illness
- Conclusion
- Introduction
- What is Meant by Recovery after Critical Illness?
- Models of Follow-Up Care
- Follow-Up Clinic Consultation
- Follow-Up Clinic Interventions
- Future Directions
- 7.1 How to Identify and Attempt to Minimise the Physical and Psychosocial Consequences of Critical Illness for Patients and Families?
- 7.2 Principles of Assessment, Prevention and Treatment of Pain in Intensive Care
- 7.3 Sedation and Neuromuscular Blockade in Intensive Care
- 7.4 Intensive Care Unit-Acquired Weakness and Physical Rehabilitation
- 7.5 Follow-Up after Critical Illness
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Index
- References
Summary
Key Learning Points
1. Around 40 per cent of patients develop clinically detectable muscle weakness known as intensive care unit-acquired weakness (ICU-AW) that can lead to long-term functional deficit.
2. Accurate diagnosis of ICU-AW can be achieved through nerve conduction studies, electromyography, muscle biopsy and ultrasound of muscle cross-sectional area; however, more commonly, a clinical diagnosis is made using the Medical Research Council (MRC) Sum Score of muscle strength.
3. Prevention and timely management of sepsis is the optimal way to mitigate the risk of ICU-AW.
4. Minimising sedation, optimising pain relief, encouraging spontaneous breathing, early mobility and family engagement are the foundations of best quality care.
5. Rehabilitation should start early after admission to the intensive care unit and continue to at least 3 months after hospital discharge.
- Type
- Chapter
- Information
- Intensive Care MedicineThe Essential Guide, pp. 663 - 665Publisher: Cambridge University PressPrint publication year: 2021
References
References and Further Reading
National Institute for Health and Care Excellence. 2017. Rehabilitation after critical illness in adults. Quality standard [QS158]. www.nice.org.uk/guidance/qs158Google Scholar
Puthucheary, ZA, Rawal, J, McPhail, M, et al. Acute skeletal muscle wasting in critical illness. JAMA 2013;310:1591–600.CrossRefGoogle ScholarPubMed
Schaller, S, Anstey, M, Blobner, M, et al. Early, goal-directed mobilisation in the surgical intensive care unit: a randomised controlled trial. Lancet 2016;388:1377–88.CrossRefGoogle ScholarPubMed
Society of Critical Care Medicine. 2018. ICU Liberation Bundle (A–F). www.sccm.org/ICULiberation/ABCDEF-BundlesGoogle Scholar
Wright, SE, Thomas, K, Watson, G, et al. Intensive versus standard physical rehabilitation therapy in the critically ill (EPICC): a multicentre, parallel-group, randomised controlled trial. Thorax 2017;73:213–21.Google ScholarPubMed