Rehabilitation interventions for postintensive care syndrome: a systematic review
| Autor: | Frank M. Brunkhorst, Michel Wensing, Konrad Schmidt, Ute Troitzsch, Antje Freytag, Peter Schlattmann, Juliane Mehlhorn, Jochen Gensichen, Juergen Graf |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Geriatric rehabilitation Activities of daily living Critical Care business.industry Critical Illness Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] MEDLINE Psychological intervention Aftercare CINAHL PsycINFO Critical Care and Intensive Care Medicine Intensive Care Units Quality of life (healthcare) Treatment Outcome Activities of Daily Living Physical therapy Quality of Life Medicine Humans Female Disease management (health) business |
| Zdroj: | Critical Care Medicine, 42, 5, pp. 1263-71 Critical Care Medicine, 42, 1263-71 |
| ISSN: | 0090-3493 |
| DOI: | 10.1097/ccm.0000000000000148 |
| Popis: | Item does not contain fulltext OBJECTIVE: An increasing number of ICU patients survive and develop mental, cognitive, or physical impairments. Various interventions support recovery from this postintensive care syndrome. Physicians in charge of post-ICU patients need to know which interventions are effective. DATA SOURCES: Systematic literature search in databases (MEDLINE, EMBASE, Cochrane CENTRAL, PsycInfo, CINAHL; 1991-2012), reference lists, and hand search. STUDY SELECTION: We included comparative studies of rehabilitation interventions in adult post-ICU patients if they considered health-related quality of life, frequency/severity of postintensive care syndrome symptoms, functional recovery, need for care, autonomy in activities of daily living, mortality, or hospital readmissions. DATA EXTRACTION: Two reviewers extracted data and assessed risk of bias independently. DATA SYNTHESIS: From 4,761 publications, 18 studies with 2,510 patients were included. Studies addressed 20 outcomes, using 45 measures, covering inpatient (n = 4 trials), outpatient (n = 9), and mixed (n = 5) healthcare settings. Eight controlled trials with moderate to high quality were considered for evaluation of effectiveness. They investigated inpatient geriatric rehabilitation, ICU follow-up clinic, outpatient rehabilitation, disease management, and ICU diaries. Five of these trials assessed posttraumatic stress disorder, with four trials showing positive effects: first, ICU diaries reduced new-onset posttraumatic stress disorder (5% vs 13%, p = 0.02) after 3 months and second showed a lower mean Impact of Event Scale-Revised score (21.0 vs 32.1, p = 0.03) after 12 months. Third, aftercare by ICU follow-up clinic reduced Impact of Event Scale for women (20 vs 31; p < 0.01). Fourth, a self-help manual led to fewer patients scoring high in the Impact of Event Scale after 8 weeks (p = 0.026) but not after 6 months. For none of the other outcomes did more than one study report positive impacts. CONCLUSION: Interventions which have substantial effects in post-ICU patients are rare. Positive effects were seen for ICU-diary interventions for posttraumatic stress disorder. More interventions for the growing number of ICU survivors are needed. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|