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KIN 335 > Exercise in the ICU > Flashcards

Exercise in the ICU Flashcards

1
Q

What is the ICU?

A
  • Special department of hospital that provides intensive care medicine
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2
Q

What kind of patients are in the ICU?

A
  • Seriously/Critically Ill
  • Risk of or recovering from life-threatening conditions
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3
Q

What are some common conditions treated in the ICU?

A
  • Acute respiratory distress syndrome
  • Septic Shock
  • Other life-threatening conditions
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4
Q

What is common with patients in the ICU?

A
  • Muscle Dysfunction
    -peripheral
    -respiratory
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5
Q

Why is muscle dysfunction common in patients in the intensive care unit?

A
  • Inactivity
  • Inflammation
  • Pharmacologic Agents
  • Neuromuscular syndromes with critical illness
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6
Q

What might respiratory muscle weakness be at its onset?

A
  • Important factor, leading to prolonged ICU stay
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7
Q

Why might respiratory muscle weakness onset be a factor leading to prolonged ICU stay?

A
  • Weaning failure from mechanical ventilation
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8
Q

How prevalent is peripheral muscle weakness in patients with mechanical ventilation for 4-7 days?

A

25-33%

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9
Q

How prevalent is peripheral muscle weakness in patients with acute respiratory distress syndrome?

A

60%

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10
Q

How prevalent is peripheral muscle weakness in patients with septic shock?

A

35-76%

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11
Q

What is peripheral muscle weakness linked within the ICU?

A
  • Increased Mortality
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12
Q

What does a prolonged ICU stay contribute to?

A
  • Impaired functional status
  • Impaired quality of life
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13
Q

How long can a prolonged ICU stay contribute to impaired functional status and quality of life?

A
  • Possibly 1 year after discharge
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14
Q

What is associated with impaired functional status? What is not associated with it?

A

Is
- Muscle Weakness
Is NOT
- Pulmonary Function

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15
Q

When is muscle wasting the highest during an ICU stay?

A
  • During first 2-3 weeks
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16
Q

What is important for patients with expected prolonged bed rest regarding muscle wasting?

A
  • Important to prevent or attenuate muscle deconditioning as early as possible
17
Q

What does the European Respiratory Society and Society of Intensive Care Medicine advice regarding critically ill patients?

A
  • Start early with active and passive exercise
18
Q

What was the rational for the study on early exercise in critically ill patients?

A
  • Prolonged stay in ICU associated with muscle dysfunction
  • Muscle dysfunction contributes to impaired functional status up to 1 year after discharge.
19
Q

What was the objective of the study on early exercise in critically ill patients?

A
  • Investigate whether daily exercise is safe and effective for preventing decrease in functional exercise capacity, functional status, and quadriceps force associated with prolonged ICU stay
20
Q

What was the design of the study on early exercise in critically ill patients?

A
  • Randomized Controlled Trial
21
Q

What was the setting of the study on early exercise in critically ill patients?

A
  • Medical/surgical ICU at University Hospital Gasthuisberg
22
Q

Who were the patients in the study on early exercise in critically ill patients?

A
  • 90 critically ill patients
  • Starting day 5 of recovery
  • expected prolonged ICU stay
23
Q

What was the intervention of the study on early exercise in critically ill patients?

A

Both Groups
- Respiratory physiotherapy
- Standardized passive/active motion session of upper and lower limbs
Treatment Group
- Passive or active exercise training session 20min/day using bedside ergometer bike

24
Q

Describe the exercise intervention used in the treatment group of the study on early exercise in critically ill patients?

A
  • 5 days a week, 20min/day
  • Bedside cycle ergometer
  • Divided into two bouts of 10min
  • Individually adjusted intensity level
25
Q

Why did they use a cycle ergometer for the study on early exercise in critically ill patients?

A
  • Offers passive or active cycling at 6 levels increasing resistance
26
Q

What were the results of the study on early exercise in critically ill patients?

A
  • Daily cycle exercise is feasible and safe during early ICU stay
  • Intervention improved functional exercise capacity, muscle force, and perceived functional status at discharge
  • increased quad strength and 6 minute walking distance
27
Q

What was the aim of the study on early bedside cycle exercise on GI function in ICU patients on MV?

A
  • Investigate effects of daily exercise on GI function in patients with severe pneumonia who received MV
28
Q

What are patients in the ICU often treated for regarding GI?

A
  • Dysfunction or disease
  • Vomiting
  • Gastric residual volumes
  • Diarrhea
  • Bowel Dilation
29
Q

What occurs in approximately 50% of critically ill patients?

A
  • Feeding Intolerance due to delayed gastric emptying
30
Q

What is a common and well-known complication that influences adverse outcomes in critically ill patients?

A
  • Gastrointestinal failure
31
Q

What was the experimental design of the study on early exercise to counter GI distress in ICU patients?

A
  • Randomized Controlled Trial
  • Tertiary Hospital
32
Q

What were the two patient groups in the study on early exercise for ICU patients who were on MV?

A
  • Control
  • Treatment: Passive/Active ergometer 20min/day
33
Q

When was gastrointestinal function and nutritional status evaluated during the study on early exercise for ICU patients with MV?

A
  • first, fourth, and seventh day
34
Q

What were the results of the study on early exercise for ICU patients who were on MV?

A
  • Treatment group had significantly lower rates of diarrhea than control
  • Treatment group had higher albumin/lymphocyte levels
  • Treatment group had less invasive ventilation days
35
Q

What is the conclusion of the study on early exercise in ICU patients who had MV?

A
  • Early exercise in critical ICU survivors who received MV enhanced the recovery of GI function and improved patient’s nutrition status at discharge

KIN 335 (14 decks)

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