RT Book, Section
A1 Schweickert, William D.
A2 Grippi, Michael A.
A2 Elias, Jack A.
A2 Fishman, Jay A.
A2 Kotloff, Robert M.
A2 Pack, Allan I.
A2 Senior, Robert M.
A2 Siegel, Mark D.
SR Print(0)
ID 1122372478
T1 Early Mobilization of Patients in the ICU
T2 Fishman's Pulmonary Diseases and Disorders, 5e
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-179672-9
LK accessmedicine.mhmedical.com/content.aspx?aid=1122372478
RD 2024/04/18
AB Improvements  in  diagnosis  and  resuscitation  of  critically  ill  patients  have  prompted  investigation  into  the  burden  of  “survivorship.”1–5  Observational  research  has  described  substantial  morbidity  in  survivors  of  critical  illness,  including  general  deconditioning,  muscle  weakness,  dyspnea,  depression,  anxiety,  and  reduced  health-related  quality  of  life.6  A  major  catalyst  for  widespread  attention  was  the  comprehensive  observations  on  a  cohort  of  survivors  of  acute  respiratory  distress  syndrome  (ARDS).7  In  this  case  series,  patients  were  young  and  generally  healthy  prior  to  ARDS,  and  they  experienced  severe  illness  with  prolonged  critical  care.  Despite  severe  acute  lung  injury,  serial  follow-up  examinations  demonstrated  that  lung  function  generally  normalized  during  the  first  year  after  ICU  discharge.  In  contrast,  all  patients  reported  poor  function  attributed  to  the  loss  of  muscle  bulk,  proximal  limb  weakness,  and  fatigue.  Patients  exhibited  impaired  endurance,  and  only  49%  of  patients  had  returned  to  work.  At  5  years  after  ICU  discharge,  subjective  weakness  and  decreased  exercise  capacity  continued.8  Although  77%  of  patients  were  working  by  the  fifth  year,  patients  often  required  a  modified  work  schedule,  gradual  transition  back  to  work,  or  job  retraining.  In  addition,  patients  were  plagued  with  psychological  illness.  More  than  half  of  survivors  experienced  at  least  one  episode  of  depression  or  anxiety.