SUPPORT VENTILATION  SMART 2002 Milan, May 29-31, 2002 Free access

Minerva Anestesiologica 2002 May;68(5):341-5

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Muscle retraining in the ICU patients

Nava S., Piaggi G., De Mattia E., Carlucci A.

From the Respiratory Intensive Care Unit Rehabilitation Center of Pavia IRCCS, S. Maugeri Foundation, Pavia

One of the ­most com­mon caus­es of an ICU admis­sion is a ­severe epi­sode of ­acute res­pir­a­to­ry fail­ure due ­either to an exac­er­ba­tion of chron­ic pul­mo­nary dis­ease or its ex-­novo devel­op­ment ­after a sur­gi­cal pro­ce­dure, trau­ma or med­i­cal com­pli­ca­tions. ­These ­patients usu­al­ly ­report, at admis­sion to the ICU, a sed­en­tary ­life ­before the ­acute epi­sode, ­because the evo­lu­tion of the dis­ease is char­ac­ter­ized by a pro­gres­sive ­decline not ­only in res­pir­a­to­ry func­tion (e.g. FEV1), but ­also in the func­tion­al stat­us, due to the ­effects of ­lack of exer­cise, ­drug admin­is­tra­tion, mal­nu­tri­tion and, lat­er on, gas ­exchange abnor­mal­ities. Togeth­er ­with spe­cif­ic ­vital ­organ sup­port, ­such as mechan­i­cal ven­ti­la­tion, ­patients admit­ted to an ICU may ­require oth­er com­plex and inte­grat­ed inter­ven­tions in ­order to main­tain the ­spared func­tion and to pre­vent fur­ther dam­age. ­These inter­ven­tions ­include nutri­tion­al and psy­cho­log­i­cal sup­port, coun­sel­ling, nurs­ing, pre­ven­tion (e.g. to pre­serve ­skin integ­rity) and in par­tic­u­lar a com­plete phys­io­the­rap­ic pro­gram, ­that may ­range ­from sim­ple ­help to main­tain a cor­rect pos­ture to com­plete recov­ery of walk­ing auton­o­my.