Recent Advances in Pulmonary Rehabilitation for Patients in the Intensive Care Unit (ICU)
Journal Title: Pulmonary Research and Respiratory Medicine – Open Journal - Year 2017, Vol 0, Issue 2
Abstract
Pulmonary rehabilitation is important to prevent complications in critically ill patients in the intensive care unit (ICU) who are on mechanical ventilation. However, the effectiveness and adverse events related to pulmonary rehabilitation for patients in the ICU are largely unclear because of the diversity of diseases and various levels of severity in this situation. This review aims to clarify the evidence currently available for pulmonary rehabilitation in critically ill adult patients requiring mechanical ventilation, with a focus on positioning and early mobilization. Prone positioning (PP) does not seem to benefit adults with hypoxemia mechanically ventilated in the ICU. However, it improved survival among patient subgroups like those enrolled within 48 h of meeting the trial entry criteria, those treated with PP for ≥16 h per day, and those with severe hypoxemia at trial entry. PP using the protective lung ventilation strategy for patients with acute respiratory distress syndrome was associated with reduced mortality. On the other hand, PP may cause pressure sores and tracheal tube obstruction. The semi-recumbent position may prevent ventilator-associated pneumonia with no adverse events. Early mobilization (EM) enhances mobility status and muscle strength and increases days of life and out of the hospital for up to 6 months; it also shortens the duration of delirium. The main adverse events with EM are hemodynamic changes and desaturation. Therefore, medical staff should carry out pulmonary rehabilitation for patients in the ICU, given the effectiveness and adverse events. Future studies should identify diseases that would benefit from pulmonary rehabilitation and optimize the method.
Authors and Affiliations
Ryuhei Sato
Keywords
Related Articles
- EP ID EP560491
- DOI 10.17140/PRRMOJ-SE-2-107
- Views 109
- Downloads 0
Diaphragm Ultrasonography as an Important Aid to Diagnose Spinal Cord Injury
An 84-year-old man was transferred from a local hospital to our hospital because of a spinal cord injury. He was admitted to the local hospital 4 days prior to the transfer after he tripped and fell, and hit his head in...
Pulmonary Rehabilitation in Patients With Pulmonary Hypertension
Traditionally, patients with pulmonary hypertension (PH) were advised to limit their physical activity because of the risk of fatal cardiovascular compromise. However, relatively little is known about the risks and benef...
The Importance of Rehabilitation before and after Lung Transplantation
Lung transplantation (LTx) has gained widespread acceptance as a therapeutic option for end-stage pulmonary disease. LTx has been shown to improve quality of life (QoL) and survival in individuals with various end-stage...
Recent Advances in Rehabilitation for Aspiration Pneumonia
Respiration and swallowing are intimately related to each other. The respiration center and the swallowing center in the brain stem are located very closely and the activation of each center inhibits the other center in...
Diagnosis and Management of Spontaneous Pneumothorax in the Emergency Department: A Review of the Most Current Clinical Evidence for Diagnosis and Treatment
Background Spontaneous non-traumatic pneumothorax is a relatively common clinical presentation in the Emergency Department. The diagnosis of spontaneous non-traumatic pneumothorax has evolved from basic chest radiography...