• Debilidad muscular
• Early mobilization
• Fármacos vasoconstrictores
• Intensive care unit
• Movilización temprana
• Muscle weakness
• Shock
• Unidad de cuidados intensivos
• Vasoconstrictor drugs

• Humans
• Intensive Care Units
• Observational Studies as Topic
• Early Ambulation/adverse effects
• Vasoconstrictor Agents/therapeutic use
• Shock/drug therapy
• Critical Care/methods
• Feasibility Studies

• Artificial intelligence
• Critical care
• Intensive care unit-acquired weakness
• Machine learning
• Neural network
• Prediction
• Risk factors

• critical illness
• critically ill
• intensive care unit
• very elderly patients

• Humans
• Retrospective Studies
• Aged, 80 and over
• Critical Illness/mortality
• Critical Illness/therapy
• Male
• Female
• Intensive Care Units/statistics & numerical data
• Germany/epidemiology
• Comorbidity
• Hospital Mortality
• Respiration, Artificial/statistics & numerical data
• Length of Stay/statistics & numerical data
• Cohort Studies
• Age Factors

• critically ill patients
• intensive care unit‐acquired weakness
• mechanical ventilation
• neuromuscular electrical stimulation
• physical activity

• Humans
• Male
• Respiration, Artificial/adverse effects
• Female
• Muscle Weakness/therapy
• Muscle Weakness/prevention & control
• Intensive Care Units
• Middle Aged
• Electric Stimulation Therapy/methods
• Single-Blind Method
• Critical Illness
• Egypt
• Adult
• Exercise Therapy/methods
• Early Ambulation/methods
• Treatment Outcome
• Length of Stay/statistics & numerical data

• brain injury
• intensive care units
• rehabilitation
• robotics
• vibration
• virtual reality

• ICUAW
• intensive care unit-acquired weakness
• long-term survivors
• muscle weakness
• pain

• Aged
• Cohort Studies
• Critical Care
• Critical Illness
• Female
• Humans
• Incidence
• Intensive Care Units
• Male
• Middle Aged
• Quality of Life
• Survivors

• COVID-19
• ICU-related weakness
• critical illness myopathy
• critical illness neuropathy
• critical illness polyneuromyopathy

• Critical Care
• Critical Illness
• Humans
• Intensive Care Units
• Muscular Diseases/therapy
• Neuromuscular Diseases
• Polyneuropathies/therapy

• covid-19
• dyspnea
• functional capacity
• inspiratory muscle training
• mechanical ventilation
• quality of life

• Adult
• Breathing Exercises/methods
• COVID-19/physiopathology
• Female
• Humans
• Male
• Middle Aged
• Pilot Projects
• Prospective Studies
• Quality of Life
• Respiratory Muscles/physiopathology
• SARS-CoV-2
• Ventilator Weaning/methods

• barriers to recovery
• community
• critical care
• critical illness survivors
• discharge
• nursing
• phenomenology
• pics
• recovery

• adult intensive & critical care
• internal medicine
• medical history

• Aged
• Cohort Studies
• Critical Care
• Female
• Functional Status
• Hospital Mortality
• Humans
• Intensive Care Units
• London/epidemiology
• Male
• Middle Aged
• Patient Admission
• Prospective Studies
• Retrospective Studies
• Routinely Collected Health Data

• critical care
• muscle mass
• nutrition support practice
• outcomes research/quality

The early use of neuromuscular electrical stimulation (NMES) to prevent intensive care unit-acquired weakness (ICU-AW) in critical patients is still a controversial topic. We conducted a systematic review to clarify the effectiveness of NMES in preventing ICU-AW.

The Cochrane Library, PubMed, EMBASE, MEDLINE, Web of Science, Ovid, CNKI, Wanfang, VIP, China Biology Medicine disc (CBMdisc) and other databases were searched for randomized controlled trials on the influence of NMES on ICU-AW. The studies were selected according to the inclusion and exclusion criteria. After data and quality were evaluated, a meta-analysis was performed by RevMan 5.3 software.

A total of 11 randomized controlled trials with 576 patients were included. The meta-analysis results showed that NMES can improve muscle strength [MD = 1.78, 95% CI (0.44, 3.12, P = 0.009); shorten the mechanical ventilation (MV) time [SMD = −0.65, 95% CI (−1.03, −0.27, P = 0.001], ICU length of stay [MD = −3.41, 95% CI (−4.58, −4.24), P < 0.001], and total length of stay [MD = −3.97, 95% CI (−6.89, −1.06, P = 0.008]; improve the ability of patients to perform activities of daily living [SMD = 0.9, 95% CI (0.45, 1.35), P = 0.001]; and increase walking distance [MD = 239.03, 95% CI (179.22298.85), P < 0.001]. However, there is no evidence indicating that NMES can improve the functional status of ICU patients during hospitalization, promote the early awakening of patients or reduce mortality (P > 0.05).

Early implementation of the NMES intervention in ICU patients can prevent ICU-AW and improve their quality of life by enhancing their muscle strength and shortening the MV duration, length of stay in the ICU and total length of stay in the hospital.

• Activities of daily living
• Electrical stimulation
• Intensive care unit
• Length of stay
• Mechanical ventilation
• Muscle strengths
• Quality of life
• Weakness

• feasibility
• intensive care unit
• multi-trauma
• muscle mass
• nutrition

• Critical illness
• Exercise
• Mechanical ventilation
• Oxygen consumption
• Rehabilitation

To assess the Perme mobility scale score as a predictor of functional status and complications in the postoperative period in patients undergoing liver transplantation.

The sample consisted of 30 patients who underwent liver transplantation. The patients were evaluated at two time points to determine their perception of pain, degree of dyspnea, peripheral muscle strength, and functional status according to the Perme scale. The collected data were analyzed by descriptive and inferential statistics. To compare the means between the evaluations, Student's t test for paired samples was applied. In case of asymmetry, the Wilcoxon test was used. In the evaluation of the association between the quantitative variables, the Pearson or Spearman correlation tests were applied.

A total of 30 individuals who underwent liver transplantation were included. The patients were predominantly male, and the mean age was 58.4 ± 9.9 years. The most prevalent underlying pathology was cirrhosis C virus (23.3%). Significant associations of the time on mechanical ventilation with the Perme scale score at discharge from the intensive care unit (r = -0.374; p = 0.042) and the number of physical therapy treatments (r = -0.578; p = 0.001) were recorded. When comparing the results of the initial evaluation and the evaluation at hospital discharge, there was a significant improvement in functional status (p < 0.001).

Functional mobility, peripheral muscle strength, pain perception, and dyspnea are significantly improved at hospital discharge compared with those at inpatient unit admission.

• Aged
• Chronic Disease
• Clinical Decision-Making
• Critical Care/statistics & numerical data
• England
• Facilities and Services Utilization
• Family Health
• Frail Elderly/psychology
• Frail Elderly/statistics & numerical data
• Frailty/psychology
• Frailty/therapy
• Humans
• Length of Stay/statistics & numerical data
• Quality Improvement
• Quality of Life
• Referral and Consultation
• Risk Assessment
• Terminal Care/standards

• Critical care
• Critical illness
• Dietary protein
• Enteral nutrition
• Intensive care
• Nutritional requirements
• Nutritional support

• Melbourne Health Foundation

• Cardiac Surgical Procedures
• Cross-Sectional Studies
• Female
• Humans
• Intensive Care Units/statistics & numerical data
• Length of Stay
• Male
• Middle Aged
• Physical Therapists
• Regression Analysis
• Retrospective Studies
• Time Factors

• UL1 TR000117 NCATS NIH HHS

• autophagy
• mitochondria
• muscle atrophy
• satellite cell
• ubiquitin–proteasome system

• Exercise training
• Lung transplantation
• Physical activity
• Physical therapy
• Rehabilitation

• Critical care
• Critical illness
• Exercise
• Exercise therapy
• Intensive care
• Intensive care units
• Length of stay
• Questionnaires
• Rehabilitation

• Critical illness
• ICU mobility
• Intensive care unit
• Quality improvement

• ADL level
• Critically ill patients
• Early rehabilitation
• Immobilisation
• Muscle atrophy
• Site specificity

• PICU
• acute rehabilitation
• critical illness
• culture change
• early mobility
• mobilization
• pediatric
• post-intensive care syndrome

• KL2 RR025006 NCRR NIH HHS

Mobilisation of patients in the intensive care unit (ICU) is an area of growing research. Currently, there is little data on baseline mobilisation practises and the barriers to them for patients of all admission diagnoses.

The objectives of the study were to (1) quantify and benchmark baseline levels of mobilisation in Australian and Scottish ICUs, (2) compare mobilisation practises between Australian and Scottish ICUs and (3) identify barriers to mobilisation in Australian and Scottish ICUs. We conducted a prospective, observational, cohort study with a 4-week inception period. Patients were censored for follow-up upon ICU discharge or after 28 days, whichever occurred first. Patients were included if they were >18 years of age, admitted to an ICU and received mechanical ventilation in the ICU.

Ten tertiary ICUs in Australia and nine in Scotland participated in the study. The Australian cohort had a large proportion of patients admitted for cardiothoracic surgery (43.3 %), whereas the Scottish cohort had none. Therefore, comparison analysis was done after exclusion of patients admitted for cardiothoracic surgery. In total, 60.2 % of the 347 patients across 10 Australian ICUs and 40.1 % of the 167 patients across 9 Scottish ICUs mobilised during their ICU stay (p < 0.001). Patients in the Australian cohort were more likely to mobilise than patients in the Scottish cohort (hazard ratio 1.83, 95 % confidence interval 1.38–2.42). However, the percentage of episodes of mobilisation where patients were receiving mechanical ventilation was higher in the Scottish cohort (41.1 % vs 16.3 %, p < 0.001). Sedation was the most commonly reported barrier to mobilisation in both the Australian and Scottish cohorts. Physiological instability and the presence of an endotracheal tube were also frequently reported barriers.

This is the first study to benchmark baseline practise of early mobilisation internationally, and it demonstrates variation in early mobilisation practises between Australia and Scotland.

The aim of this study was to investigate current mobilization practice, strength at ICU discharge and functional recovery at 6 months among mechanically ventilated ICU patients.

This was a prospective, multi-centre, cohort study conducted in twelve ICUs in Australia and New Zealand. Patients were previously functionally independent and expected to be ventilated for >48 hours. We measured mobilization during invasive ventilation, sedation depth using the Richmond Agitation and Sedation Scale (RASS), co-interventions, duration of mechanical ventilation, ICU-acquired weakness (ICUAW) at ICU discharge, mortality at day 90, and 6-month functional recovery including return to work.

We studied 192 patients (mean age 58.1 ± 15.8 years; mean Acute Physiology and Chronic Health Evaluation (APACHE) (IQR) II score, 18.0 (14 to 24)). Mortality at day 90 was 26.6% (51/192). Over 1,351 study days, we collected information during 1,288 planned early mobilization episodes in patients on mechanical ventilation for the first 14 days or until extubation (whichever occurred first). We recorded the highest level of early mobilization. Despite the presence of dedicated physical therapy staff, no mobilization occurred in 1,079 (84%) of these episodes. Where mobilization occurred, the maximum levels of mobilization were exercises in bed (N = 94, 7%), standing at the bed side (N = 11, 0.9%) or walking (N = 26, 2%). On day three, all patients who were mobilized were mechanically ventilated via an endotracheal tube (N = 10), whereas by day five 50% of the patients mobilized were mechanically ventilated via a tracheostomy tube (N = 18).

In 94 of the 156 ICU survivors, strength was assessed at ICU discharge and 48 (52%) had ICU-acquired weakness (Medical Research Council Manual Muscle Test Sum Score (MRC-SS) score <48/60). The MRC-SS score was higher in those patients who mobilized while mechanically ventilated (50.0 ± 11.2 versus 42.0 ± 10.8, P = 0.003). Patients who survived to ICU discharge but who had died by day 90 had a mean MRC score of 28.9 ± 13.2 compared with 44.9 ± 11.4 for day-90 survivors (P <0.0001).

Early mobilization of patients receiving mechanical ventilation was uncommon. More than 50% of patients discharged from the ICU had developed ICU-acquired weakness, which was associated with death between ICU discharge and day-90.

ClinicalTrials.gov NCT01674608. Registered 14 August 2012.

ICU-acquired weakness can hinder and determine the course of recovery from critical illness, leading to life-changing disability. Risk factors include multiorgan failure and prolonged bed rest; however, no prognostic model or screening tool for new-onset disability has been established to date. With no way of targeting the at-risk population, it is difficult to demonstrate the benefit of rehabilitation interventions in research and prioritize resources clinically. In a recent issue of Critical Care, Schandl and colleagues aimed to establish a predictive screening tool for new-onset disability using 23 possible predictors. They found that using the following risk factors – low educational level, fractures, reduced core stability and length of ICU stay over 2 days – they were able to develop a risk score predictive of disability at 2 months after hospital discharge. These investigators propose that this will help to identify patients requiring follow-up and may increase the power to detect change in interventional studies. Whilst this is promising work, further validation is essential: firstly, to make it a clinically workable tool in terms of appropriate ‘cut offs’; secondly, to ensure that it is transferable in different socio-economic environments; and finally, to make sure that those identified as ‘at risk’ are those that would benefit the most from targeted intervention.

• Acute Kidney Injury/physiopathology
• Acute Kidney Injury/therapy
• Aged
• Creatinine/urine
• Female
• Glomerular Filtration Rate/physiology
• Humans
• Intensive Care Units
• Kidney Function Tests/methods
• Length of Stay/statistics & numerical data
• Male
• Middle Aged
• Outcome Assessment, Health Care
• Sensitivity and Specificity
• Treatment Outcome

• atrophy
• botulinum toxin
• contractile function
• embryonic stem cells
• skeletal muscle

• Cognitive impairment
• Critical care
• Patient safety
• Psychology
• Rehabilitation

Severe trauma is accompanied by a period of hypermetabolism and disuse. In this study, a rat model was used to determine the effects of burn and disuse independently and in combination on body composition, food intake and adipokines.

Male rats were assigned to four groups 1) sham ambulatory (SA), 2) sham hindlimb unloaded (SH), 3) 40% total body surface area full thickness scald burn ambulatory (BA) and 4) burn and hindlimb unloaded (BH). Animals designated to the SH and BH groups were placed in a tail traction system and their hindlimbs unloaded. Animals were followed for 14 days. Plasma, urine, fecal and tissue samples were analyzed.

SA had a progressive increase in body mass (BM), SH and BA no change and BH a reduction. Compared to SA, BM was reduced by 10% in both SH and BA and by 17% when combined in BH. Compared to SA, all groups had reductions in lean and fat body mass with BH being greater. The decrease in lean mass was associated with the rate of urinary corticosterone excretion. The loss in fat mass was associated with decreases in plasma leptin and adiponectin and an increase in ghrelin. Following the acute response to injury, BH had a greater food intake per 100 g BM. Food intake was associated with the levels of leptin, adiponectin and ghrelin.

The effects of the combination of burn and disuse in this animal model were additive, therefore in assessing metabolic changes with severe trauma both injury and disuse should be considered. Furthermore, the observed changes in adipokines, corticosterone and ghrelin provide insights for interventions to attenuate the hypermetabolic state following injury, possibly reducing catabolism and muscle loss and subsequent adverse effects on recovery and function.