Feasibility and Validity of the Coma Recovery Scale-Revised for Accelerated Standardized Testing: A Practical Assessment Tool for Detecting Consciousness in the Intensive Care Unit.

We developed and validated an abbreviated version of the Coma Recovery Scale-Revised (CRS-R), the CRS-R For Accelerated Standardized Testing (CRSR-FAST), to detect conscious awareness in patients with severe traumatic brain injury in the intensive care unit. In 45 consecutively enrolled patients, CRSR-FAST administration time was approximately one-third of the full-length CRS-R (mean [SD] 6.5 [3.

Subjective Assessment of Motor Function by the Bedside Nurses in Mechanically Ventilated Surgical Intensive Care Unit Patients Predicts Tracheostomy.

Objective: In many institutions, intensive care unit (ICU) nurses assess their patients' muscle function as part of their routine bedside examination. We tested the research hypothesis that this subjective examination of muscle function prior to extubation predicts tracheostomy requirement.

Methods: Adult, mechanically ventilated patients admitted to 7 ICUs at Beth Israel Deaconess Medical Center (BIDMC) between 2008 and 2019 were included in this observational study.

Effects of the Level and Duration of Mobilization Therapy in the Surgical ICU on the Loss of the Ability to Live Independently: An International Prospective Cohort Study.

Objectives: It is unclear whether early mobilization in the surgical ICU helps improve patients' functional recovery to a level that enables independent living. We assessed dose of mobilization (level + duration). We tested the research hypotheses that dose of mobilization predicts adverse discharge and that both duration of mobilization and maximum mobilization level predict adverse discharge.

A multidisciplinary approach to decreasing length of stay in acute care surgery patients.

Aim: To decrease hospital length of stay in acute care surgery patients.

Design: An observational cohort quality improvement project at a single tertiary referral centre.

Methods: A multidisciplinary team of physicians, nurses, case managers, and physical and occupational therapists was created to identify patients at risk for prolonged length of stay and implement weekly multidisciplinary rounding, with a systematic method of tracking progress in real time.

Prospective Observational Study of Predictors of Re-Intubation Following Extubation in the Surgical ICU.

Background: Re-intubation is associated with high morbidity and mortality. There is limited information regarding the risk factors that predispose patients admitted to the surgical ICU to re-intubation. We hypothesized that preoperative comorbidities, acquired muscular weakness, and renal dysfunction would be predictors of re-intubation in the surgical ICU population.

Surgical Intensive Care Unit Optimal Mobilisation Score (SOMS) trial: a protocol for an international, multicentre, randomised controlled trial focused on goal-directed early mobilisation of surgical ICU patients.

Introduction: Immobilisation in the intensive care unit (ICU) leads to muscle weakness and is associated with increased costs and long-term functional disability. Previous studies showed early mobilisation of medical ICU patients improves clinical outcomes. The Surgical ICU Optimal Mobilisation Score (SOMS) trial aims to test whether a budget-neutral intervention to facilitate goal-directed early mobilisation in the surgical ICU improves participant mobilisation and associated clinical outcomes.

Muscle weakness predicts pharyngeal dysfunction and symptomatic aspiration in long-term ventilated patients.

Background: Prolonged mechanical ventilation is associated with muscle weakness, pharyngeal dysfunction, and symptomatic aspiration. The authors hypothesized that muscle strength measurements can be used to predict pharyngeal dysfunction (endoscopic evaluation-primary hypothesis), as well as symptomatic aspiration occurring during a 3-month follow-up period.

Methods: Thirty long-term ventilated patients admitted in two intensive care units at Massachusetts General Hospital were included.

Global muscle strength but not grip strength predicts mortality and length of stay in a general population in a surgical intensive care unit.

Background: Paresis acquired in the intensive care unit (ICU) is common in patients who are critically ill and independently predicts mortality and morbidity. Manual muscle testing (MMT) and handgrip dynamometry assessments have been used to evaluate muscle weakness in patients in a medical ICU, but similar data for patients in a surgical ICU (SICU) are limited.

Objective: The purpose of this study was to evaluate the predictive value of strength measured by MMT and handgrip dynamometry at ICU admission for in-hospital mortality, SICU length of stay (LOS), hospital LOS, and duration of mechanical ventilation.

The surgical intensive care unit optimal mobility score predicts mortality and length of stay.

Objectives: To test if the surgical intensive care unit optimal mobility score predicts mortality and intensive care unit and hospital length of stay.

Design: Prospective single-center cohort study.

Setting: Surgical intensive care unit of the Massachusetts General Hospital.

Early mobilization in critically ill patients: patients' mobilization level depends on health care provider's profession.

Objective: To evaluate whether the level of mobilization achieved and the barriers for progressing to the next mobilization level differ between nurses and physical therapists.

Design: Prospective, observational study.

Setting: Twenty-bed surgical intensive care unit (SICU) of the Massachusetts General Hospital.