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  1. Article ; Online: Early Mobilization Dose Reporting in Randomized Clinical Trials with Patients Who Were Mechanically Ventilated: A Scoping Review.

    González-Seguel, Felipe / Letelier-Bernal, Renato

    Physical therapy

    2024  

    Abstract: Objective: The aim of this scoping review was to investigate the mobilization dose reporting in the randomized clinical trials (RCTs) of patients receiving mechanical ventilation in the intensive care unit.: Methods: In this scoping review, RCTs ... ...

    Abstract Objective: The aim of this scoping review was to investigate the mobilization dose reporting in the randomized clinical trials (RCTs) of patients receiving mechanical ventilation in the intensive care unit.
    Methods: In this scoping review, RCTs published from inception to December 2022 were searched in relevant electronic databases. Trials that involved adults receiving mechanical ventilation (>48 hours) and any early mobilization modality were analyzed. Two independent authors screened, selected, and extracted data. The mobilization doses of the intervention groups (IG) and the comparator groups (CG) were assessed as the proportion of reported items/total applicable from the main items of the Consensus on Exercise Reporting Template (CERT).
    Results: Twenty-three RCTs comprising 2707 patients (1358 from IG and 1349 from CG) were included, involving studies on neuromuscular electrical stimulation (n = 7), progressive mobility (n = 6), leg cycling (n = 3), tilt table (n = 1), and multicomponent (n = 6) mobilization. The pooled reporting of CERT items was 68% (86% for IG and 50% for CG). The most reported CERT items were type of exercise (100%) and weekly frequency (100%) for IG, whereas the least reported were intensity (4%) and individualization (22%) for CG. Regardless of the group, individualization, progression, and intensity of mobilization were the least reported items. Eight IGs (35%) reported all CERT items, whereas no CGs reported all of them.
    Conclusions: Deficits in mobilization dose reporting of intensive care unit RCTs were identified, especially for exercise intensity in adults receiving mechanical ventilation. One-third of IG reported all exercise dosing items, whereas no CG reported all of them. Future studies should investigate the details of optimal dosage reporting, particularly for CG.
    Impact: The lack of dose reporting may partially explain the inconsistency in the meta-analysis results of early mobilization trials, thus limiting the interpretation for clinical practice in the intensive care unit.
    Language English
    Publishing date 2024-03-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 415886-6
    ISSN 1538-6724 ; 0031-9023
    ISSN (online) 1538-6724
    ISSN 0031-9023
    DOI 10.1093/ptj/pzae048
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  2. Article ; Online: Evaluación del funcionamiento físico en cuidados críticos: encuesta nacional en más de 90 centros chilenos durante la pandemia por COVID-19.

    González-Seguel, Felipe / Cáceres-Parra, Camilo

    Revista medica de Chile

    2023  Volume 150, Issue 12, Page(s) 1565–1574

    Abstract: Background: Physical functioning evaluation in intensive care units (ICUs) identifies rehabilitation requirements and response to interventions.: Aim: To identify the usage rate of physical functioning measurement instruments in ICUs during the COVID- ...

    Title translation Physical functioning assessment tools in critical care: a wide national survey in Chile during the COVID-19 pandemic.
    Abstract Background: Physical functioning evaluation in intensive care units (ICUs) identifies rehabilitation requirements and response to interventions.
    Aim: To identify the usage rate of physical functioning measurement instruments in ICUs during the COVID-19 pandemic in Chile.
    Material and methods: Lead physiotherapists representing different national ICUs were invited to answer a National online survey at the onset (T1) and at the first year of COVID-19 pandemic (T2). The usage rate (defined as "always"/"almost always"/"almost never"/"never") of instruments assessing muscle strength, muscle mass, mobility, and physical performance was surveyed. Also, the reasons for selecting these instruments were requested.
    Results: We received responses from 94 and 93 ICUs at T1 and T2, respectively, of 111 eligible ICUs (55% public). Compared with T2, the usage rate of instruments was lower at T1, and significant only for Medical Research Sum-Score (MRC-SS) (p = 0.04) and handgrip dynamometry (p = 0.05). Considering the answers "always", "almost always" and "almost never", between 89% and 91% of the ICUs reported the use of the MRC-SS; between 70% and 73% reported the use of the Functional Status Score for the Intensive Care Unit; between 5% and 35% of the ICUs reported the use of the rest of mobility scales; and between 44%-45% of ICUs reported that muscle ultrasound was "almost never" used. The main reasons reported for selecting instruments were quick use and clinimetric properties.
    Conclusions: The usage rate of muscle strength assessments was frequent, while the use of mobility and muscle mass instruments recommended by the literature was poorly reported, which was lower at the onset of the pandemic.
    MeSH term(s) Humans ; Pandemics ; Hand Strength ; Chile/epidemiology ; COVID-19 ; Critical Care ; Intensive Care Units
    Language Spanish
    Publishing date 2023-10-25
    Publishing country Chile
    Document type English Abstract ; Journal Article
    ZDB-ID 732136-3
    ISSN 0717-6163 ; 0034-9887
    ISSN (online) 0717-6163
    ISSN 0034-9887
    DOI 10.4067/s0034-98872022001201565
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  3. Article ; Online: Respiratory drive, inspiratory effort, and work of breathing: review of definitions and non-invasive monitoring tools for intensive care ventilators during pandemic times.

    Ríos-Castro, Francisco / González-Seguel, Felipe / Molina, Jorge

    Medwave

    2022  Volume 22, Issue 3, Page(s) e8724

    Abstract: Technological advances in mechanical ventilation have been essential to increasing the survival rate in intensive care units. Usually, patients needing mechanical ventilation use controlled ventilation to override the patients respiratory muscles and ... ...

    Title translation Impulso, esfuerzo y trabajo respiratorio: revisión de definiciones y herramientas no invasivas de ventiladores de cuidados intensivos durante tiempos de pandemia.
    Abstract Technological advances in mechanical ventilation have been essential to increasing the survival rate in intensive care units. Usually, patients needing mechanical ventilation use controlled ventilation to override the patients respiratory muscles and favor lung protection. Weaning from mechanical ventilation implies a transition towards spontaneous breathing, mainly using assisted mechanical ventilation. In this transition, the challenge for clinicians is to avoid under and over assistance and minimize excessive respiratory effort and iatrogenic diaphragmatic and lung damage. Esophageal balloon monitoring allows objective measurements of respiratory muscle activity in real time, but there are still limitations to its routine application in intensive care unit patients using mechanical ventilation. Like the esophageal balloon, respiratory muscle electromyography and diaphragmatic ultrasound are minimally invasive tools requiring specific training that monitor respiratory muscle activity. Particularly during the coronavirus disease pandemic, non invasive tools available on mechanical ventilators to monitor respiratory drive, inspiratory effort, and work of breathing have been extended to individualize mechanical ventilation based on patients needs. This review aims to identify the conceptual definitions of respiratory drive, inspiratory effort, and work of breathing and to identify non invasive maneuvers available on intensive care ventilators to measure these parameters. The literature highlights that although respiratory drive, inspiratory effort, and work of breathing are intuitive concepts, even distinguished authors disagree on their definitions.
    MeSH term(s) Critical Care ; Humans ; Pandemics ; Respiration, Artificial ; Ventilators, Mechanical ; Work of Breathing/physiology
    Language English
    Publishing date 2022-04-29
    Publishing country Chile
    Document type Journal Article ; Review
    ZDB-ID 2818022-7
    ISSN 0717-6384 ; 0717-6384
    ISSN (online) 0717-6384
    ISSN 0717-6384
    DOI 10.5867/medwave.2022.03.002550
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  4. Article ; Online: Effectiveness of physical rehabilitation interventions in critically ill patients-A protocol for an overview of systematic reviews.

    Gutierrez-Arias, Ruvistay / Nydahl, Peter / Pieper, Dawid / González-Seguel, Felipe / Jalil, Yorschua / Oliveros, Maria-Jose / Torres-Castro, Rodrigo / Seron, Pamela

    PloS one

    2023  Volume 18, Issue 4, Page(s) e0284417

    Abstract: Introduction: Adult and pediatric patients admitted to intensive care units (ICUs) requiring invasive ventilatory support, sedation, and muscle blockade may present neuromusculoskeletal deterioration. Different physical rehabilitation interventions have ...

    Abstract Introduction: Adult and pediatric patients admitted to intensive care units (ICUs) requiring invasive ventilatory support, sedation, and muscle blockade may present neuromusculoskeletal deterioration. Different physical rehabilitation interventions have been studied to evaluate their effectiveness in improving critically ill patients' outcomes. Given that many published systematic reviews (SRs) aims to determine the effectiveness of different types of physical rehabilitation interventions, it is necessary to group them systematically and assess the methodological quality of SRs to help clinicians make better evidence-based decisions. This overview of SRs (OoSRs) aims to map the existing evidence and to determine the effectiveness of physical rehabilitation interventions to improve neuromusculoskeletal function and other clinical outcomes in adult and pediatric critically ill patients.
    Methods: An OoSRs of randomized and non-randomized clinical trials involving critically ill adult and pediatric patients receiving physical rehabilitation intervention will be conducted. A sensitive search of MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), Cochrane Library, Epistemonikos, and other search resources will be conducted. Two independent reviewers will conduct study selection, data extraction, and methodological quality assessment. Discrepancies will be resolved by consensus or a third reviewer. The degree of overlap of studies will be calculated using the corrected covered area. The methodological quality of the SRs will be measured using the AMSTAR-2 tool. The GRADE framework will report the certainty of evidence by selecting the "best" SR for each physical rehabilitation intervention and outcome.
    Discussion: The findings of this overview are expected to determine the effectiveness and safety of physical rehabilitation interventions to improve neuromusculoskeletal function in adult and pediatric critically ill patients based on a wide selection of the best available evidence and to determine the knowledge gaps in this topic by mapping and assessing the methodological quality of published SRs.
    Registration number: CRD42023389672.
    MeSH term(s) Adult ; Child ; Humans ; Critical Illness ; Hospitalization ; Intensive Care Units ; Systematic Reviews as Topic
    Language English
    Publishing date 2023-04-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0284417
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  5. Article ; Online: Six-month post-intensive care outcomes during high and low bed occupancy due to the COVID-19 pandemic: A multicenter prospective cohort study.

    Castro-Avila, Ana / Merino-Osorio, Catalina / González-Seguel, Felipe / Camus-Molina, Agustín / Muñoz-Muñoz, Felipe / Leppe, Jaime

    PloS one

    2023  Volume 18, Issue 11, Page(s) e0294631

    Abstract: Introduction: The COVID-19 pandemic can be seen as a natural experiment to test how bed occupancy affects post-intensive care unit (ICU) patient's functional outcomes. To compare by bed occupancy the frequency of mental, physical, and cognitive ... ...

    Abstract Introduction: The COVID-19 pandemic can be seen as a natural experiment to test how bed occupancy affects post-intensive care unit (ICU) patient's functional outcomes. To compare by bed occupancy the frequency of mental, physical, and cognitive impairments in patients admitted to ICU during the COVID-19 pandemic.
    Methods: Prospective cohort of adults mechanically ventilated >48 hours in 19 ICUs from seven Chilean public and private hospitals. Ninety percent of nationwide beds occupied was the cut-off for low versus high bed occupancy. At ICU discharge, 3- and 6-month follow-up, we assessed disability using the World Health Organization Disability Assessment Schedule 2.0. Quality of life, mental, physical, and cognitive outcomes were also evaluated following the core outcome set for acute respiratory failure.
    Results: We enrolled 252 participants, 103 (41%) during low and 149 (59%) during high bed occupancy. Patients treated during high occupancy were younger (P50 [P25-P75]: 55 [44-63] vs 61 [51-71]; p<0.001), more likely to be admitted due to COVID-19 (126 [85%] vs 65 [63%]; p<0.001), and have higher education qualification (94 [63%] vs 48 [47%]; p = 0.03). No differences were found in the frequency of at least one mental, physical or cognitive impairment by bed occupancy at ICU discharge (low vs high: 93% vs 91%; p = 0.6), 3-month (74% vs 63%; p = 0.2) and 6-month (57% vs 57%; p = 0.9) follow-up.
    Conclusions: There were no differences in post-ICU outcomes between high and low bed occupancy. Most patients (>90%) had at least one mental, physical or cognitive impairment at ICU discharge, which remained high at 6-month follow-up (57%).
    Clinical trial registration: NCT04979897 (clinicaltrials.gov).
    MeSH term(s) Adult ; Humans ; Bed Occupancy ; Prospective Studies ; COVID-19/epidemiology ; Pandemics ; Quality of Life ; Critical Care ; Intensive Care Units
    Language English
    Publishing date 2023-11-16
    Publishing country United States
    Document type Multicenter Study ; Journal Article
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0294631
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  6. Article ; Online: Assessment of redundancy, methodological and reporting quality, and potential discrepancies of results of systematic reviews of early mobilisation of critically ill adults: a meta-research protocol.

    Gutierrez-Arias, Ruvistay / Pieper, Dawid / Nydahl, Peter / González-Seguel, Felipe / Jalil, Yorschua / Oliveros, Maria-Jose / Torres-Castro, Rodrigo / Seron, Pamela

    BMJ open

    2023  Volume 13, Issue 7, Page(s) e074615

    Abstract: Introduction: Several systematic reviews (SRs) have been conducted to determine the effectiveness of early mobilisation in critically ill adults with heterogeneous methodology and results. Redundancy in conducting SRs, unclear justification when leading ...

    Abstract Introduction: Several systematic reviews (SRs) have been conducted to determine the effectiveness of early mobilisation in critically ill adults with heterogeneous methodology and results. Redundancy in conducting SRs, unclear justification when leading new SRs or updating, and discordant results of SRs on the same research question may generate research waste that makes it difficult for clinicians to keep up to date with the best available evidence. This meta-research aims to assess the redundancy, methodological and reporting quality, and potential reasons for discordance in the results reported by SRs conducted to determine the effectiveness of early mobilisation in critically ill adult patients.
    Methods and analysis: A meta-research of early mobilisation SRs in critically ill adult patients will be conducted. A search of MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), Cochrane Library, Epistemonikos and other search resources will be conducted. Two independent reviewers will perform study selection, data extraction and quality appraisal. Discrepancies will be resolved by consensus or a third reviewer. The redundancy of SRs will be assessed by the degree of overlap of primary studies. In addition, the justification for conducting new SRs will be evaluated with the 'Evidence-Based Research' framework. The methodological quality of the SRs will be assessed with the A MeaSurement Tool to Assess systematic Reviews 2 tool, and the quality of the reports through compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. To assess the potential reasons for discordance in the results of the SRs considering divergence in results and their interpretation.
    Ethics and dissemination: As meta-research, this study does not involve the participation of people whose rights may be violated. However, this overview will be developed rigorously and systematically to achieve valid and reliable results. The findings of this meta-research study will be presented at conferences and published in a peer-reviewed journal related to rehabilitation, critical care or research methodology.
    Trial registration number: osf.io/kxwq9.
    MeSH term(s) Adult ; Humans ; Critical Illness/therapy ; Early Ambulation ; Critical Care ; Research Design ; Peer Review
    Language English
    Publishing date 2023-07-20
    Publishing country England
    Document type Journal Article
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2023-074615
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  7. Article ; Online: Adverse Events of Prone Positioning in Mechanically Ventilated Adults With ARDS.

    González-Seguel, Felipe / Pinto-Concha, Juan José / Aranis, Nadine / Leppe, Jaime

    Respiratory care

    2021  Volume 66, Issue 12, Page(s) 1898–1911

    Abstract: Background: Prone positioning is a therapy utilized globally to improve gas exchange, minimize ventilator-induced lung injury, and reduce mortality in ARDS, particularly during the ongoing coronavirus disease 2019 (COVID-19) pandemic. Whereas the ... ...

    Abstract Background: Prone positioning is a therapy utilized globally to improve gas exchange, minimize ventilator-induced lung injury, and reduce mortality in ARDS, particularly during the ongoing coronavirus disease 2019 (COVID-19) pandemic. Whereas the respiratory benefits of prone positioning in ARDS have been accepted, the concurrent complications could be undervalued. Therefore, this study aimed to identify the adverse events (AEs) related to prone positioning in ARDS and, secondarily, to collect strategies and recommendations to mitigate these AEs.
    Methods: In this scoping review, we searched recommendation documents and original studies published between June 2013 and November 2020 from 6 relevant electronic databases and the websites of intensive care societies.
    Results: We selected 41 documents from 121 eligible documents, comprising 13 recommendation documents and 28 original studies (involving 1,578 subjects and 994 prone maneuvers). We identified > 40 individual AEs, and the highest-pooled occurrence rates were those of severe desaturation (37.9%), barotrauma (30.5%), pressure sores (29.7%), ventilation-associated pneumonia (28.2%), facial edema (16.7%), arrhythmia (15.4%), hypotension (10.2%), and peripheral nerve injuries (8.1%). The reported mitigation strategies during prone positioning included alternate face rotation (18 [43.9%]), repositioning every 2 h (17 [41.5%]), and the use of pillows under the chest and pelvis (14 [34.1%]). The reported mitigation strategies for performing the prone maneuver comprised one person being at the headboard (23 [56.1%]), the use of a pre-maneuver safety checklist (18 [43.9%]), vital sign monitoring (15 [36.6%]), and ensuring appropriate ventilator settings (12 [29.3%]).
    Conclusions: We identified > 40 AEs reported in prone positioning ARDS studies, including additional AEs not yet reported by previous systematic reviews. The pooled AE proportions collected in this review could guide research and clinical practice decisions, and the strategies to mitigate AEs could promote future consensus-based recommendations.
    MeSH term(s) Adult ; COVID-19 ; Humans ; Patient Positioning ; Prone Position ; Respiration, Artificial/adverse effects ; Respiratory Distress Syndrome/etiology ; Respiratory Distress Syndrome/therapy ; SARS-CoV-2
    Language English
    Publishing date 2021-07-23
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 603252-7
    ISSN 1943-3654 ; 0098-9142 ; 0020-1324
    ISSN (online) 1943-3654
    ISSN 0098-9142 ; 0020-1324
    DOI 10.4187/respcare.09194
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  8. Article ; Online: Intensive Care Unit-Acquired Weakness in Patients With Acute Kidney Injury: A Contemporary Review.

    Teixeira, J Pedro / Mayer, Kirby P / Griffin, Benjamin R / George, Naomi / Jenkins, Nathaniel / Pal, C Anil / González-Seguel, Felipe / Neyra, Javier A

    American journal of kidney diseases : the official journal of the National Kidney Foundation

    2022  Volume 81, Issue 3, Page(s) 336–351

    Abstract: Acute kidney injury (AKI) and intensive care unit-acquired weakness (ICU-AW) are 2 frequent complications of critical illness that, until recently, have been considered unrelated processes. The adverse impact of AKI on ICU mortality is clear, but its ... ...

    Abstract Acute kidney injury (AKI) and intensive care unit-acquired weakness (ICU-AW) are 2 frequent complications of critical illness that, until recently, have been considered unrelated processes. The adverse impact of AKI on ICU mortality is clear, but its relationship with muscle weakness-a major source of ICU morbidity-has not been fully elucidated. Furthermore, improving ICU survival rates have refocused the field of intensive care toward improving long-term functional outcomes of ICU survivors. We begin our review with the epidemiology of AKI in the ICU and of ICU-AW, highlighting emerging data suggesting that AKI and AKI treated with kidney replacement therapy (AKI-KRT) may independently contribute to the development of ICU-AW. We then delve into human and animal data exploring the pathophysiologic mechanisms linking AKI and acute KRT to muscle wasting, including altered amino acid and protein metabolism, inflammatory signaling, and deleterious removal of micronutrients by KRT. We next discuss the currently available interventions that may mitigate the risk of ICU-AW in patients with AKI and AKI-KRT. We conclude that additional studies are needed to better characterize the epidemiologic and pathophysiologic relationship between AKI, AKI-KRT, and ICU-AW and to prospectively test interventions to improve the long-term functional status and quality of life of AKI survivors.
    MeSH term(s) Humans ; Quality of Life ; Intensive Care Units ; Critical Care ; Renal Replacement Therapy/adverse effects ; Acute Kidney Injury/therapy ; Critical Illness
    Language English
    Publishing date 2022-11-02
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 604539-x
    ISSN 1523-6838 ; 0272-6386
    ISSN (online) 1523-6838
    ISSN 0272-6386
    DOI 10.1053/j.ajkd.2022.08.028
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  9. Article ; Online: International Classification of Functioning, Disability, and Health Domains of 60 Physical Functioning Measurement Instruments Used During the Adult Intensive Care Unit Stay: A Scoping Review.

    González-Seguel, Felipe / Corner, Evelyn Jane / Merino-Osorio, Catalina

    Physical therapy

    2019  Volume 99, Issue 5, Page(s) 627–640

    Abstract: Background: There has been a recent surge in the creation and adaptation of instruments to measure physical functioning (PF) in the intensive care unit (ICU). Selecting the right measurement instrument depends on understanding the core constructs that ... ...

    Abstract Background: There has been a recent surge in the creation and adaptation of instruments to measure physical functioning (PF) in the intensive care unit (ICU). Selecting the right measurement instrument depends on understanding the core constructs that it measures in terms of the International Classification of Functioning, Disability and Health (ICF) domains.
    Purpose: The purpose of this study was to map systematically the ICF domains and subdomains included in the PF measurement instruments used for adult patients during the ICU stay.
    Data sources: A systematic search was carried out in Cochrane CENTRAL, PubMed, CINAHL, and LILACS as well as a hand search up to May 17, 2017.
    Study selection: Study selection included all types of research articles that used at least 1 PF measurement instrument in adult patients within the ICU.
    Data extraction: Study design, year of publication, study population, and the measurement instruments reported were recorded. A consensus of experts analyzed the ICF domains included in each instrument.
    Data synthesis: We found 181 articles containing 60 PF measurement instruments used during the ICU stay. Twenty-six ICF domains were identified, 38 instruments included Mobility, and 13 included Muscle function.
    Limitations: Studies not written in English or Spanish were excluded.
    Conclusions: There are numerous PF measurement instruments used in adult patients in the ICU. The most frequent ICF domain measured is Mobility. This study highlights the ICF domains contained in the instruments that can be used clinically, providing a complete database of instruments that could facilitate selection of the most appropriate measure based on the patients' needs.
    MeSH term(s) Activities of Daily Living ; Disability Evaluation ; Humans ; Intensive Care Units ; International Classification of Functioning, Disability and Health/standards
    Language English
    Publishing date 2019-01-01
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 415886-6
    ISSN 1538-6724 ; 0031-9023
    ISSN (online) 1538-6724
    ISSN 0031-9023
    DOI 10.1093/ptj/pzy158
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  10. Article ; Online: Construct Validity of the Chilean-Spanish Version of the Functional Status Score for the Intensive Care Unit: A Prospective Observational Study Using Actigraphy in Mechanically Ventilated Patients.

    Camus-Molina, Agustín / González-Seguel, Felipe / Castro-Ávila, Ana Cristina / Leppe, Jaime

    Archives of physical medicine and rehabilitation

    2020  Volume 101, Issue 11, Page(s) 1914–1921

    Abstract: Objective: To evaluate the construct validity (hypotheses testing) of the Chilean-Spanish version of the Functional Status Score for the Intensive Care Unit (FSS-ICU) using continuous actigraphy from intensive care unit (ICU) admission to ICU discharge.! ...

    Abstract Objective: To evaluate the construct validity (hypotheses testing) of the Chilean-Spanish version of the Functional Status Score for the Intensive Care Unit (FSS-ICU) using continuous actigraphy from intensive care unit (ICU) admission to ICU discharge.
    Design: The Chilean-Spanish version of the FSS-ICU was used in a prospective observational study to mainly evaluate its correlation with actigraphy variables. The FSS-ICU was assessed on awakening and at ICU discharge, while actigraphy variables were recorded from ICU admission to ICU discharge.
    Setting: A 12-bed academic medical-surgical ICU.
    Participants: Mechanically ventilated patients (N=30), of 92 patients screened.
    Interventions: Not applicable.
    Main outcome measures: Construct validity of the FSS-ICU Chilean-Spanish version was assessed by testing 12 hypotheses, including the correlation with activity counts, activity time (>99 counts/min), inactivity time (0-99 counts/min), muscle strength, ICU length of stay, and duration of mechanical ventilation.
    Results: The median FSS-ICU was 19 points (interquartile range [IQR], 10-26 points) on awakening and 28.5 points (IQR, 22-32 points) at ICU discharge. There was no floor/ceiling effect of the FSS-ICU at awakening (0%/0%) and only a ceiling effect at ICU discharge that was acceptable (0%/10%). Less activity time was associated with better mobility on the FSS-ICU at both awakening (ρ=-0.62, P<.001) and ICU discharge (ρ=-0.79, P<.001). Activity counts and activity time were not correlated as expected with the FSS-ICU.
    Conclusions: The Chilean-Spanish FSS-ICU had a strong correlation with inactivity time during the ICU stay. These findings enhance the available clinimetric properties of the FSS-ICU.
    MeSH term(s) APACHE ; Actigraphy/standards ; Aged ; Chile ; Critical Care Outcomes ; Disability Evaluation ; Female ; Functional Status ; Humans ; Intensive Care Units/statistics & numerical data ; Length of Stay/statistics & numerical data ; Male ; Middle Aged ; Muscle Strength ; Patient Discharge/statistics & numerical data ; Prospective Studies ; Reproducibility of Results ; Respiration, Artificial/statistics & numerical data ; Time Factors
    Language English
    Publishing date 2020-05-21
    Publishing country United States
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 80057-0
    ISSN 1532-821X ; 0003-9993
    ISSN (online) 1532-821X
    ISSN 0003-9993
    DOI 10.1016/j.apmr.2020.04.019
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