Feasibility of Exercise Testing in Patients Who Are Critically Ill: A Prospective, Observational Multicenter Study.


Journal

Archives of physical medicine and rehabilitation
ISSN: 1532-821X
Titre abrégé: Arch Phys Med Rehabil
Pays: United States
ID NLM: 2985158R

Informations de publication

Date de publication:
02 2019
Historique:
received: 08 02 2018
revised: 07 07 2018
accepted: 10 07 2018
pubmed: 25 8 2018
medline: 2 11 2019
entrez: 25 8 2018
Statut: ppublish

Résumé

To evaluate the feasibility and safety of exercise testing and to describe the physiological response to exercise of patients in the Intensive Care Unit (ICU). A prospective observational multicenter study. Two mixed medical-surgical ICUs. Patients (N=37; with no primary neurological disorders, 59% men; median age 50y; ICU length of stay 14.5d; Acute Physiology and Chronic Health Evaluation IV 73.0) who had been mechanically ventilated for more than 48 hours and were hemodynamically stable enough to perform physical exercise. A passive or active incremental exercise test, depending on muscle strength, on a bed-based cycle ergometer. Feasibility and safety were evaluated based on protocol adherence and adverse events. Physiological responses to exercise quantified as changes in respiratory frequency (RF), oxygen uptake (Vo Thirty-seven patients of whom 18 were mechanically ventilated underwent the exercise test. The active incremental test was performed by 28, and the passive test by 9 participants. Thirty-three (89%) accomplished the test according to the protocol and 1 moderate severe adverse event (bradycardia; heart rate 44) occurred shortly after the test. RF, Vo It is safe and feasible to perform exercise testing on a bed-based cycle ergometer in patients who are critically ill and a physiological response could be measured. Future research should investigate the clinical value of exercise testing in daily ICU practice and whether exercise capacity and its limiting factors could be determined by incremental exercise testing.

Identifiants

pubmed: 30142315
pii: S0003-9993(18)30937-7
doi: 10.1016/j.apmr.2018.07.430
pii:
doi:

Substances chimiques

Lactic Acid 33X04XA5AT

Types de publication

Journal Article Multicenter Study Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

239-246

Informations de copyright

Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Auteurs

Juultje Sommers (J)

Amsterdam UMC, University of Amsterdam, Department of Rehabilitation Medicine, Amsterdam, Movement Sciences Amsterdam, The Netherlands. Electronic address: j.sommers@amc.uva.nl.

Emily Klooster (E)

Department of Rehabilitation, Deventer Hospital, Deventer, The Netherlands.

Siebrand B Zoethout (SB)

Department of Rehabilitation, Deventer Hospital, Deventer, The Netherlands.

Huub L A van den Oever (HLA)

Department of Intensive Care Medicine, Deventer Hospital, Deventer, The Netherlands.

Frans Nollet (F)

Amsterdam UMC, University of Amsterdam, Department of Rehabilitation Medicine, Amsterdam, Movement Sciences Amsterdam, The Netherlands.

Robert Tepaske (R)

Amsterdam UMC, University of Amsterdam, Department of Intensive Care Medicine, Amsterdam.

Janneke Horn (J)

Amsterdam UMC, University of Amsterdam, Department of Intensive Care Medicine, Amsterdam.

Raoul H H Engelbert (RHH)

Amsterdam UMC, University of Amsterdam, Department of Rehabilitation Medicine, Amsterdam, Movement Sciences Amsterdam, The Netherlands; ACHIEVE, Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.

Marike van der Schaaf (M)

Amsterdam UMC, University of Amsterdam, Department of Rehabilitation Medicine, Amsterdam, Movement Sciences Amsterdam, The Netherlands; ACHIEVE, Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.

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Classifications MeSH