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      Physiotherapy treatment approaches for survivors of critical illness: a proposal from a Delphi study

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          Most cited references15

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          Consensus measurement in Delphi studies

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            Neuromuscular dysfunction acquired in critical illness: a systematic review.

            To determine the prevalence, risk factors, and outcomes of critical illness neuromuscular abnormalities (CINMA). Systematic review. MEDLINE, EMBASE, CINAHL, and the Cochrane Library were searched for reports on adult ICU patients who were evaluated for CINMA clinically and electrophysiologically. Studies were included if they contained sufficient data to quantify the association between CINMA and relevant exposures and/or outcome variables. CINMA was diagnosed in 655 of 1421 [46% (95% confidence interval 43-49%)] adult ICU patients enrolled in 24 studies, all with inclusion criteria of sepsis, multi-organ failure, or prolonged mechanical ventilation. Diagnostic criteria for CINMA were not uniform, and few reports unequivocally differentiated between polyneuropathy, myopathy, and mixed types of CINMA. The risk of CINMA was associated with hyperglycemia (and inversely associated with tight glycemic control), the systemic inflammatory response syndrome, sepsis, multiple organ dysfunction, renal replacement therapy, and catecholamine administration. Across studies, there was no consistent relationship between CINMA and patient age, gender, severity of illness, or use of glucocorticoids, neuromuscular blockers, aminoglycosides, or midazolam. Unadjusted mortality was not increased in the majority of patients with CINMA, but mechanical ventilation and ICU and hospital stay were prolonged. The risk of CINMA is nearly 50% in ICU patients with sepsis, multi-organ failure, or protracted mechanical ventilation. The association of CINMA with frequently cited CINMA risk factors (glucocorticoids, neuromuscular blockers) and with short-term survival is uncertain. Available data indicate glycemic control as a potential strategy to decrease CINMA risk.
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              Increased Hospital-Based Physical Rehabilitation and Information Provision After Intensive Care Unit Discharge: The RECOVER Randomized Clinical Trial.

              Critical illness results in disability and reduced health-related quality of life (HRQOL), but the optimum timing and components of rehabilitation are uncertain.
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                Author and article information

                Journal
                Physiotherapy Theory and Practice
                Physiotherapy Theory and Practice
                Informa UK Limited
                0959-3985
                1532-5040
                March 2019
                March 2019
                : 1-11
                Affiliations
                [1 ] Amsterdam UMC, University of Amsterdam, Department of Rehabilitation, Amsterdam Movement Sciences, Amsterdam, Netherlands
                [2 ] ACHIEVE - Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
                [3 ] European School of Physiotherapy, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
                Article
                10.1080/09593985.2019.1579283
                30821565
                b5a0f40c-381d-411e-ac69-41d8af7ef797
                © 2019

                http://creativecommons.org/licenses/by-nc-nd/4.0/

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