Background: In-bed cycling (IBC) is gaining interest for implementation in intensive care units. Our main objective was to explore patient recollections and experiences of early mobilization, including IBC. Secondly, we aimed to examine if IBC was safe and feasible.
Methods: Eleven participants were interviewed about their experiences during their critical illnesses and active mobilization in the intensive care unit. The interviews were analyzed thematically. Six participants were also monitored for physiological reactions and adverse events during IBC while mechanically ventilated.
Results: From the interviews, one main theme with three subthemes was identified. The main theme was: Early mobilization gave a direction toward normalization. The three subthemes were: (1) IBC gave a feeling of control over recovery early on during the critical illness (2) Early mobilization, including IBC, with continuous support from health care professionals gave a feeling of safety and hope for recovery for the patient; and (3) Unpleasant experiences and disorientation were felt during the critical illness and IBC. Furthermore, IBC did not induce large physiological changes or major adverse events in the participants who were monitored for feasibility and safety.
Conclusions: Patient interviews indicated that the patients' participation in early mobilization with emphasis on IBC motivated them to be active in their recovery to regain a good level of health after their earlier critical illness during their intensive care stay. IBC was, in this small study, safe and feasible in the two participating intensive care units.
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http://dx.doi.org/10.1111/aas.13070 | DOI Listing |
Drugs Aging
January 2025
Program for the Care and Study of the Aging Heart, Department of Medicine, Weill Cornell Medicine, 420 East 70th St, New York, NY, LH-36510063, USA.
There are several pharmacologic agents that have been touted as guideline-directed medical therapy for heart failure with preserved ejection fraction (HFpEF). However, it is important to recognize that older adults with HFpEF also contend with an increased risk for adverse effects from medications due to age-related changes in pharmacokinetics and pharmacodynamics of medications, as well as the concurrence of geriatric conditions such as polypharmacy and frailty. With this review, we discuss the underlying evidence for the benefits of various treatments in HFpEF and incorporate key considerations for older adults, a subpopulation that may be at higher risk for adverse drug events.
View Article and Find Full Text PDFJ Clin Monit Comput
January 2025
Department of Anaesthesiology and Intensive Care, Bicetre hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Le Kremlin Bicetre, France.
Intravenous fluid is administered during high-risk surgery to optimize stroke volume (SV). To assess ongoing need for fluids, the hemodynamic response to a fluid bolus is evaluated using a fluid challenge technique. The Acumen Assisted Fluid Management (AFM) system is a decision support tool designed to ease the application of fluid challenges and thus improve fluid administration during high-risk surgery.
View Article and Find Full Text PDFIndian J Pediatr
January 2025
Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, India.
Objectives: To evaluate the predictive ability of furosemide stress test (FST), serum and urine cystatin-C in identifying progressive acute kidney injury (AKI) and the need for kidney replacement therapy (KRT).
Methods: Children aged one month to 18 y admitted in the pediatric intensive care unit (PICU) with Kidney Diseases Improving Global Outcomes (KDIGO) stage-1/2 AKI were enrolled. FST and serum and urine cystatin-C levels were performed and analyzed.
Intensive Care Med Exp
January 2025
Freie Universität Berlin and Humboldt-Universität Zu Berlin, Department of Anesthesiology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
Purpose: CytoSorb® (CS) adsorbent is a hemoadsorption filter for extracorporeal blood purification often integrated into continuous kidney replacement therapy (CKRT). It is primarily used in critically ill patients with sepsis and related conditions, including cytokine storms and systemic inflammatory responses. Up to now, there is no evidence nor recommendation for the use of CS filters in sepsis (22).
View Article and Find Full Text PDFSleep Breath
January 2025
Department of Pulmonary and Critical Care Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No.1 Da Hua Road, Dong Dan, Dongcheng District, Beijing, 100730, PR China.
Purpose: To investigate the relationship between obstructive sleep apnea hypopnea syndrome (OSAHS) severity and fat, bone, and muscle indices.
Methods: This study included 102 patients with OSAHS and retrospectively reviewed their physical examination data. All patients underwent polysomnography, body composition analysis, dual-energy X-ray absorptiometry, computed tomography (CT) and blood test.
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