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Total 18703 results found since Jan 2013.

Early Protocolized Versus Usual Care Rehabilitation for Pediatric Neurocritical Care Patients: A Randomized Controlled Trial
Objective s: Few feasibility, safety, and efficacy data exist regarding ICU-based rehabilitative services for children. We hypothesized that early protocolized assessment and therapy would be feasible and safe versus usual care in pediatric neurocritical care patients. Design: Randomized controlled trial. Setting: Three tertiary care PICUs in the United States. Patients: Fifty-eight children between the ages of 3–17 years with new traumatic or nontraumatic brain insult and expected ICU admission greater than 48 hours. Interventions: Early protocolized (consultation of physical therapy, occupational therapy,...
Source: Pediatric Critical Care Medicine - June 1, 2019 Category: Pediatrics Tags: Neurocritical Care Source Type: research

Experiences of four parents with physical therapy and early mobility of their children in a pediatric critical care unit: A case series.
CONCLUSION: This study affords a preliminary understanding of parents' experiences with physical therapy and EM in a PCCU setting. Results provide an important foundation for future research on mobility in the context of pediatric critical care research and practice. PMID: 27285809 [PubMed - in process]
Source: Journal of Pediatric Rehabilitation Medicine - June 12, 2016 Category: Rehabilitation Tags: J Pediatr Rehabil Med Source Type: research

Physical and occupational therapy utilization in a pediatric intensive care unit
Conclusions Data are needed to inform on the efficacy of rehabilitative therapies initiated in the ICU to improve outcome for critically ill children.
Source: Journal of Critical Care - March 12, 2017 Category: Gastroenterology Source Type: research

Benefits of Early Mobilization After Pediatric Liver Transplantation*
Objective: To evaluate the impact of early mobilization after pediatric liver transplantation in the PICU. Design: A 70-month retrospective before-after study. Setting: Medical and surgical PICU with 20 beds at a tertiary children’s hospital. Patients: Seventy-five patients 2–18 years old who underwent liver transplantation and could walk before surgery. Intervention: We meticulously planned and implemented an early mobilization intervention, a multifaceted framework for early mobilization practice in the PICU focusing on a multidisciplinary team approach. Measurements and Main Results: There was a sig...
Source: Pediatric Critical Care Medicine - February 1, 2019 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

After the Fall: The Tapestry of Disturbance and Recovery
On July 3, 2015, Nalini Nadkarni, a world-renowned ecologist who had been studying the biologic processes of ecosystem disturbance and recovery, sustained a catastrophic 50-foot free-fall from the top of the rainforest canopy to the forest floor at her remote field research site. She lost consciousness in shock and sustained life-threatening injuries. Her accompanying students hiked out, radio-called 911, and the Harborview Medical Center (Seattle) Medivac team arrived 4 hours later to rescue her. Her prognosis was extremely grim; her family gathered in anticipation of her death as she underwent four operations during her ...
Source: Critical Care Medicine - January 19, 2017 Category: Emergency Medicine Tags: Plenary Articles Source Type: research

Physical and occupational therapy utilization in a pediatric intensive care unit
To characterize the use of physical therapy (PT) and occupational therapy (OT) consultation in our pediatric intensive care unit (PICU).
Source: Journal of Critical Care - March 6, 2017 Category: Intensive Care Authors: Liang R. Cui, Megan LaPorte, Matthew Civitello, Meg Stanger, Maxine Orringer, Frank Casey, Bradley A. Kuch, Sue R. Beers, Cynthia A. Valenta, Patrick M. Kochanek, Amy J. Houtrow, Ericka L. Fink Source Type: research

An Official American Thoracic Society Clinical Practice Guideline: The Diagnosis of Intensive Care Unit-acquired Weakness in Adults.
CONCLUSIONS: Research that identifies treatments that benefit patients with ICUAW is necessary to determine whether the benefits of diagnostic testing for ICUAW outweigh its burdens. PMID: 25496103 [PubMed - in process]
Source: American Journal of Respiratory and Critical Care Medicine - December 15, 2014 Category: Respiratory Medicine Authors: Fan E, Cheek F, Chlan L, Gosselink R, Hart N, Herridge MS, Hopkins RO, Hough CL, Kress JP, Latronico N, Moss M, Needham DM, Rich MM, Stevens RD, Wilson KC, Winkelman C, Zochodne DW, Ali NA, ATS Committee on ICU-acquired Weakness in Adults Tags: Am J Respir Crit Care Med Source Type: research

Supporting small steps toward big innovations: The importance of rigorous pilot studies in critical care
Early physical rehabilitation for critically ill patients is safe, feasible, and associated with improved muscle strength, physical function, and quality of life outcomes . However, patient severity of illness, deep sedation, and delirium still prevent many otherwise eligible patients from participating in early rehabilitation therapy in the intensive care unit . Recent investigations have started to explore very early physical therapy in deeply sedated, mechanically ventilated patients . In an article published online on March 28, 2014, in the Journal of Critical Care, Parry et al report the results of a pilot study of fu...
Source: Journal of Critical Care - April 21, 2014 Category: Intensive Care Authors: Alison E. Turnbull, Ann M. Parker, Dale M. Needham Tags: Letters/Editorials Source Type: research

Describing and measuring recovery and rehabilitation after critical illness
Purpose of review: Rehabilitation is the cornerstone of management of postcritical illness morbidity. Selection of appropriate tools to measure response to rehabilitation therapy is vital to accurately document trajectory of change across the recovery continuum. In the context of physical-based strategies to redress critical illness associated muscle wasting and dysfunction, this review will discuss a framework to guide assessment of physical recovery in the critical illness population, clinimetric measurement properties for instruments and evidence for their implementation, and recent interventional trial data. Recent fin...
Source: Current Opinion in Critical Care - September 9, 2015 Category: Nursing Tags: CRITICAL CARE OUTCOMES: Edited by Stephen Brett Source Type: research

Current Physical Therapy Practice in the Intensive Care Unit in Saudi Arabia: A Multicentre Cross-Sectional Survey.
Conclusion: PTs reported significant variation in the choice of treatment for different clinical cases inside ICU. The main barriers in the ICU setting were low confidence and inadequate training. PMID: 33457013 [PubMed]
Source: Critical Care Research and Practice - January 20, 2021 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Utilization of ICU Rehabilitation Services in Pediatric Patients With a Prolonged ICU Stay*
OBJECTIVES: To describe rehabilitation practice patterns among critically ill children with prolonged ICU stays and explore the association between institution-level utilization of rehabilitative services and patient outcomes. DESIGN: Retrospective cohort study using an administrative database of inpatient clinical and resource utilization data from participating pediatric hospitals in the United States. Center-level utilization of physical therapy and occupational therapy among critically ill patients was used to divide hospitals by quartile into high utilization centers or standard utilization centers. SETT...
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

PICU Up!: Impact of a Quality Improvement Intervention to Promote Early Mobilization in Critically Ill Children*
Objective: To determine the safety and feasibility of an early mobilization program in a PICU. Design: Observational, pre-post design. Setting: PICU in a tertiary academic hospital in the United States. Patients: Critically ill pediatric patients admitted to the PICU. Intervention: This quality improvement project involved a usual-care baseline phase, followed by a quality improvement phase that implemented a multicomponent, interdisciplinary, and tiered activity plan to promote early mobilization of critically ill children. Measurements and Main Results: Data were collected and analyzed from July to August 2014 (prei...
Source: Pediatric Critical Care Medicine - December 1, 2016 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Interventions to prevent non-critical care hospital acquired pneumonia – a systematic review
Conclusions There is currently insufficient trial evidence on preventing non-critical care hospital-acquired pneumonia to make recommendations on practice.
Source: European Geriatric Medicine - April 24, 2015 Category: Geriatrics Source Type: research

Pediatric spinal cord injury without radiographic abnormality in the era of advanced imaging
Purpose of review: The current review describes the current evidence on pediatric spinal cord injury without radiographic abnormality (SCIWORA) with attention to the definition, epidemiology, and clinical presentation of the condition, as well as common MRI findings, management strategies, and outcomes. Recent findings: Recent literature demonstrates that with more widespread MRI use, our understanding of SCIWORA has improved. The new literature, although still limited, provides a more granular conceptualization of patterns of injury as well as potential prognostic stratification of patients based on MRI findings. Through...
Source: Current Opinion in Pediatrics - May 11, 2017 Category: Pediatrics Tags: EMERGENCY AND CRITICAL CARE MEDICINE: Edited by Jean Klig and Clifford W. Bogue Source Type: research

Temporal Changes in Prescription of Neuropharmacologic Drugs and Utilization of Resources Related to Neurologic Morbidity in Mechanically Ventilated Children With Bronchiolitis*
Objectives: Critically ill children with bronchiolitis may require neuropharmacologic medications and support for neuro-functional sequelae, but current practices are not well described. We aimed to describe recent trends in neuropharmacology and utilization of neuro-rehabilitation resources in mechanically ventilated children with bronchiolitis. Design: Analysis of the multicenter Pediatric Health Information System database. Setting: Forty-seven U.S. children’s hospitals. Patients: PICU patients less than 2 years old with bronchiolitis undergoing mechanical ventilation between 2006 and 2015. Interventions: ...
Source: Pediatric Critical Care Medicine - December 1, 2017 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research