Araştırma Makalesi
BibTex RIS Kaynak Göster

Son On Yılda Yoğun Bakım Ünitesi İlişkili Kas Güçsüzlüğüne Yönelik Çalışmaların İncelenmesi: Sistematik Derleme

Yıl 2017, Cilt: 4 Sayı: 3, 1 - 12, 31.01.2018

Öz

Amaç: Bu çalışma, son on yılda dünyada yoğun bakım ünitesi ile ilişkili kas güçsüzlüğünü önlemede egzersizin etkinliği ve kasta görülen değişimleri belirlemeye yönelik yapılan çalışmaların incelenmesi amacıyla yapılmıştır. Gereç ve Yöntem: Aralık 2015 tarihinde Pubmed ve EBSCO veri tabanları kullanılarak 20052015 yılları arasında toplam 126 makaleye ulaşılmış olup; bunlardan çalışma kriterlerini karşılayan 8 çalışma örnekleme alınmıştır. Çalışmanın anahtar kelimeleri; “YBÜ-KG”, ”Kas güçsüzlüğü”, “Kritik hastalık miyopatisi”, “Kritik hastalık polinöropatisi”, “Yoğun bakım ünitesi” ve “Egzersiz” şeklindendir. Çalışmaya “YBÜ-KG ve egzersiz” konularını içeren randomize kontrollü çalışmalar (RKÇ), prospektif kohort ve prospektif gözlemsel çalışmalar dahil edilmiştir. Bulgular: Çalışmamızda, dört RKÇ, dört prospektif olmak üzere toplam sekiz çalışma incelenmiştir. İncelenen çalışmalarda hareketsizlik ile birlikte kaslarda kas gücü ve miyozin kaybının olduğu, yoğun bakımda kalış süresinin uzaması ile birlikte bu kayıpların arttığı saptanmıştır. Kas gücü azalmasına bağlı oluşan sorunun, iyileşme süresinin 12 aydan daha uzun sürdüğü görülmüştür. İncelenen çalışmalar; uygulanan egzersizin türü, süresi, yoğunluğu ve hasta popülasyonun özelliğine bakılmaksızın; hastalara yaptırılan egzersizin olumlu etkisi olduğu belirtilmiştir. Sonuç: Kas güçsüzlüğüne bağlı yapılan son on yıldaki araştırmaların yakın zamanlarda artış gösterdiği, araştırma biçimlerinin homojen olmadığı, kullanılan ölçme araçlarının farklılık gösterdiği belirlenmiştir. Yoğun bakım ünitesi ilişkili kas güçsüzlüğünde altta yatan faktörlerin belirlenmesi ve yönetiminde egzersizin etkisine yönelik daha fazla kanıt temelli çalışma yapılmasına ihtiyaç duyulduğu belirlenmiştir.

Kaynakça

  • 1. Witteveen E, Wieske L, Verhamme C, Schultz M. J, Van Schaik I. N, Horn J. Muscle and nerve inflammation in intensive care unit-acquired weakness: A systematic translational review. Journal of the neurological sciences 2014; 345(1): 15-25.
  • 2. Fan E, Zanni J M, Dennison C R, Lepre S J, Needham D M. Critical illness neuromyopathy and muscle weakness in patients in the intensive care unit. AACN advanced critical care 2009; 20(3): 243-253.
  • 3. Hermans G, Van den Berghe G. Clinical review: intensive care unit acquired weakness. Critical Care 2015; 19(1): 2-9.
  • 4. Griffiths R D, Hall JB. Intensive care unit-acquired weakness. Critical care medicine 2010; 38(3): 779-787.
  • 5. Latronico N, Peli E, Botteri M. Critical illness myopathy and neuropathy. Current opinion in critical care 2005; 11(2): 126-132.
  • 6. Lee C. M, Fan E. ICU-acquired weakness: what is preventing its rehabilitation in critically ill patients?. BMC medicine 2012; 10(1): 2-4.
  • 7. Meltem Gül L, Çelik M, Öztekin F, Devrim S, Nur Orhon Z. Yoğun Bak imdaki kas güçsüzlüğüne iki farklı bakış. Türk Anestezi ve Reanimasyon Dergisi 2011; 39(1): 43-49.
  • 8. Kress JP. Clinical trials of early mobilization of critically ill patients. Critical care medicine 2009; 37(10): 442-447.
  • 9. de Jonghe B, Lacherade J C, Sharshar T, Outin H. Intensive care unit-acquired weakness: risk factors and prevention. Critical care medicine 2009; 37(10): 309-315.
  • 10. Bunnell A, Ney J, Gellhorn A, Hough C L. Quantitative neuromuscular ultrasound in intensive care unit–acquired weakness: A systematic review. Muscle & nerve 2015; 52(5): 701-708.
  • 11. Hermans G, Wilmer A, Meersseman W, Milants I, Wouters P J, Bobbaers H. Impact of intensive insulin therapy on neuromuscular complications and ventilator dependency in the medical intensive care unit. American journal of respiratory and critical care medicine 2007; 175(5): 480-489.
  • 12. Wieske L, Witteveen E, Verhamme C, Dettling-Ihnenfeldt D S, van der Schaaf M, Schultz M J. Early Prediction of Intensive Care Unit–Acquired Weakness Using Easily Available Parameters: A Prospective Observational Study. PloS one 2014; 9(10): e111259.
  • 13. Potter P. Klinik Uygulama Becerileri ve Yöntemleri. Atabek Aştı T, Karadağ A (Çev.). Adana: Nobel Tıp Kitabevleri; 2011. s: 257-68
  • 14. Otman S, Köse N. Egzersiz Tedavisinde Temel Prensipler ve Yöntemler. Ankara: Pelikan Kitabevi; 2014. s: 21-55
  • 15. Balas MC, Vasilevskis EE, Burke WJ, Boehm L, Pun BT, Olsen KM, Peitz GJ, Ely EW. (2012). Critical Care Nurses’ Role in Implementing the “ABCDE Bundle” into Practice. Critical Care Nurse 32(2): 35–48. doi:10.4037/ccn2012229
  • 16. Delirium: Diagnosis, prevention and management. NICE clinical guideline. Erişim Tarihi: 13.02.2015 http://www.nice.org.uk/guidance/cg103
  • 17. Barr J, Fraser GL, Puntillo K, Ely EW, Gélinas C, Dasta JF, Davidson JE, Devlin JW, Kress JP, Joffe AM, Coursin DB, Herr DL, Tung A, Robinson BR, Fontaine DK, Ramsay MA, Riker RR, Sessler CN, Pun B, Skrobik Y, Jaeschke R. (2013). Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit. Critical Care Medicine 41(1): 263-306. doi: 10.1097/CCM.0b013e3182783b72
  • 18. Angel M J, Bril V, Shannon P, Herridge M S. Neuromuscular function in survivors of the acute respiratory distress syndrome. The Canadian Journal of Neurological Sciences 2007; 34(04): 427-432.
  • 19. Fan E, Dowdy D W, Colantuoni E, Mendez-Tellez P A, Sevransky J E, Shanholtz C et al. Physical complications in acute lung injury survivors: a 2-year longitudinal prospective study. Critical care medicine 2014; 42(4): 849-859.
  • 20. Novak P, Vidmar G, Kuret Z, Bizovicar N. Rehabilitation of critical illness polyneuropathy and myopathy patients: an observational study. International Journal of Rehabilitation Research 2011; 34(4): 336-342.
  • 21. Llano-Diez M, Renaud G, Andersson M, Marrero H G, Cacciani N, Engquist H, et al. Mechanisms underlying ICU muscle wasting and effects of passive mechanical loading. Critical Care 2012; 16(5): 1-16.
  • 22. Connolly B, Thompson A, Douiri A, Moxham J, Hart N. Exercise-based rehabilitation after hospital discharge for survivors of critical illness with intensive care unit–acquired weakness: A pilot feasibility trial. Journal of critical care 2015; 30(3): 589-598.
  • 23. Patel BK, Pohlman A S, Hall J B, Kress J P. Impact of early mobilization on glycemic control and ICUacquired weakness in critically ill patients who are mechanically ventilated. CHEST Journal 2014; 146(3): 583-589.
  • 24. Gerovasili V, Stefanidis K, Vitzilaios K, Karatzanos E, Politis P, Koroneos A. et al. Electrical muscle stimulation preserves the muscle mass of critically ill patients: a randomized study. Critical Care 2009; 13(5): 1-8.
  • 25. Angelopoulos E, Karatzanos E, Dimopoulos S, Mitsiou G, Stefanou C, Patsaki et al. Acute microcirculatory effects of medium frequency versus high frequency neuromuscular electrical stimulation in critically ill patients-a pilot study. Annals of intensive care 2013; 3(1): 1-9.
  • 26. Balas MC, Vasilevskis EE, Olsen KM, Schmid KK, Shostrom V, Cohen MZ. Effectiveness and Safety of the Awakening and Breathing Coordination, Delirium Monitoring/Management, and Early Exercise/ Mobility Bundle. Critical Care Medicine 2014; 42(5): 1024-36
  • 27. Barr J, Fraser GL, Puntillo K, Ely EW, Gélinas C, Dasta JF. Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit. Critical Care Medicine 2013; 41(1): 263-306.
  • 28. Puthucheary Z, Hart N. Intensive care unit acquired muscle weakness: when should we consider rehabilitation?. Critical Care 2009; 13(4), 1-2.
  • 29. Needham DM, Truong AD, Fan E. Technology to enhance physical rehabilitation of critically ill patients. Critical care medicine, 2009; 37(10):436-441.
  • 30. Maddocks M, Gao W, Higginson IJ, Wilcock A. Neuromuscular electrical stimulation for muscle weakness in adults with advanced disease. Cochrane Database of Systematic Reviews 2013, Issue 1. Art. No.: CD009419. DOI: 10.1002/14651858.CD009419.pub2.
  • 31. Trees D W, Smith J M, Hockert S. Innovative mobility strategies for the patient with intensive care unit– acquired weakness: a case report. Physical therapy 2013; 93(2): 237-247.
  • 32. Doiron KA, Hoffmann T, Beller EM. Early İntervention (Mobilization Or Active Exercise) For Critically Ill Patients in The İntensive Care Unit. Cochrane Database of Systematic Reviews 2013; Issue 10.

Examination of Studies on Intensive Care Unit-Acquired Muscle Weakness in Last Decade: A Systematic Review

Yıl 2017, Cilt: 4 Sayı: 3, 1 - 12, 31.01.2018

Öz

Aim: This study aims to investigate the studies conducted in last 10 years on prevention of intensive care unit acquired weakness (ICU-AW) by alteration in muscles and the effect of exercises. Material and Methods: By reaching total of 126 studies published between 2005-2015 in December 2015 via using Pubmed and EBSCO Databases, eight of these studies that met the study criteria were included in the sample. “ICU-AW”, “Muscle Weakness”, “Critical illness myopathy”, “Critical illness polyneuropathy”, “Intensive care unit”, and “Exercise” were the keywords for the study. Randomized controlled trials (RCTs), prospective cohorts and prospective observational studies that contains “ICU-AW and Exercise” issues were included in the study. Results: Total of eight studies, including four RCTs and four prospective studies, were investigated in our study. Reviewed studies showed that loss of muscle strength and myosin occurred with immobility, these losses increased with the extension of ICU stay. It was observed that recovery period of the problem caused by muscle weakness took longer than 12 months. Regardless of type, duration, intensity of exercise, and the patients’ characteristics; studies stated that exercise had positive effects. Conclusion: It has been determined that studies on ICU-AW in last ten years have recently shown an increase, research methodologies are not homogeneous, and the measuring instruments varied. More evidence-based study are needed to determine and manage the underlying factors of ICU-AW.

Kaynakça

  • 1. Witteveen E, Wieske L, Verhamme C, Schultz M. J, Van Schaik I. N, Horn J. Muscle and nerve inflammation in intensive care unit-acquired weakness: A systematic translational review. Journal of the neurological sciences 2014; 345(1): 15-25.
  • 2. Fan E, Zanni J M, Dennison C R, Lepre S J, Needham D M. Critical illness neuromyopathy and muscle weakness in patients in the intensive care unit. AACN advanced critical care 2009; 20(3): 243-253.
  • 3. Hermans G, Van den Berghe G. Clinical review: intensive care unit acquired weakness. Critical Care 2015; 19(1): 2-9.
  • 4. Griffiths R D, Hall JB. Intensive care unit-acquired weakness. Critical care medicine 2010; 38(3): 779-787.
  • 5. Latronico N, Peli E, Botteri M. Critical illness myopathy and neuropathy. Current opinion in critical care 2005; 11(2): 126-132.
  • 6. Lee C. M, Fan E. ICU-acquired weakness: what is preventing its rehabilitation in critically ill patients?. BMC medicine 2012; 10(1): 2-4.
  • 7. Meltem Gül L, Çelik M, Öztekin F, Devrim S, Nur Orhon Z. Yoğun Bak imdaki kas güçsüzlüğüne iki farklı bakış. Türk Anestezi ve Reanimasyon Dergisi 2011; 39(1): 43-49.
  • 8. Kress JP. Clinical trials of early mobilization of critically ill patients. Critical care medicine 2009; 37(10): 442-447.
  • 9. de Jonghe B, Lacherade J C, Sharshar T, Outin H. Intensive care unit-acquired weakness: risk factors and prevention. Critical care medicine 2009; 37(10): 309-315.
  • 10. Bunnell A, Ney J, Gellhorn A, Hough C L. Quantitative neuromuscular ultrasound in intensive care unit–acquired weakness: A systematic review. Muscle & nerve 2015; 52(5): 701-708.
  • 11. Hermans G, Wilmer A, Meersseman W, Milants I, Wouters P J, Bobbaers H. Impact of intensive insulin therapy on neuromuscular complications and ventilator dependency in the medical intensive care unit. American journal of respiratory and critical care medicine 2007; 175(5): 480-489.
  • 12. Wieske L, Witteveen E, Verhamme C, Dettling-Ihnenfeldt D S, van der Schaaf M, Schultz M J. Early Prediction of Intensive Care Unit–Acquired Weakness Using Easily Available Parameters: A Prospective Observational Study. PloS one 2014; 9(10): e111259.
  • 13. Potter P. Klinik Uygulama Becerileri ve Yöntemleri. Atabek Aştı T, Karadağ A (Çev.). Adana: Nobel Tıp Kitabevleri; 2011. s: 257-68
  • 14. Otman S, Köse N. Egzersiz Tedavisinde Temel Prensipler ve Yöntemler. Ankara: Pelikan Kitabevi; 2014. s: 21-55
  • 15. Balas MC, Vasilevskis EE, Burke WJ, Boehm L, Pun BT, Olsen KM, Peitz GJ, Ely EW. (2012). Critical Care Nurses’ Role in Implementing the “ABCDE Bundle” into Practice. Critical Care Nurse 32(2): 35–48. doi:10.4037/ccn2012229
  • 16. Delirium: Diagnosis, prevention and management. NICE clinical guideline. Erişim Tarihi: 13.02.2015 http://www.nice.org.uk/guidance/cg103
  • 17. Barr J, Fraser GL, Puntillo K, Ely EW, Gélinas C, Dasta JF, Davidson JE, Devlin JW, Kress JP, Joffe AM, Coursin DB, Herr DL, Tung A, Robinson BR, Fontaine DK, Ramsay MA, Riker RR, Sessler CN, Pun B, Skrobik Y, Jaeschke R. (2013). Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit. Critical Care Medicine 41(1): 263-306. doi: 10.1097/CCM.0b013e3182783b72
  • 18. Angel M J, Bril V, Shannon P, Herridge M S. Neuromuscular function in survivors of the acute respiratory distress syndrome. The Canadian Journal of Neurological Sciences 2007; 34(04): 427-432.
  • 19. Fan E, Dowdy D W, Colantuoni E, Mendez-Tellez P A, Sevransky J E, Shanholtz C et al. Physical complications in acute lung injury survivors: a 2-year longitudinal prospective study. Critical care medicine 2014; 42(4): 849-859.
  • 20. Novak P, Vidmar G, Kuret Z, Bizovicar N. Rehabilitation of critical illness polyneuropathy and myopathy patients: an observational study. International Journal of Rehabilitation Research 2011; 34(4): 336-342.
  • 21. Llano-Diez M, Renaud G, Andersson M, Marrero H G, Cacciani N, Engquist H, et al. Mechanisms underlying ICU muscle wasting and effects of passive mechanical loading. Critical Care 2012; 16(5): 1-16.
  • 22. Connolly B, Thompson A, Douiri A, Moxham J, Hart N. Exercise-based rehabilitation after hospital discharge for survivors of critical illness with intensive care unit–acquired weakness: A pilot feasibility trial. Journal of critical care 2015; 30(3): 589-598.
  • 23. Patel BK, Pohlman A S, Hall J B, Kress J P. Impact of early mobilization on glycemic control and ICUacquired weakness in critically ill patients who are mechanically ventilated. CHEST Journal 2014; 146(3): 583-589.
  • 24. Gerovasili V, Stefanidis K, Vitzilaios K, Karatzanos E, Politis P, Koroneos A. et al. Electrical muscle stimulation preserves the muscle mass of critically ill patients: a randomized study. Critical Care 2009; 13(5): 1-8.
  • 25. Angelopoulos E, Karatzanos E, Dimopoulos S, Mitsiou G, Stefanou C, Patsaki et al. Acute microcirculatory effects of medium frequency versus high frequency neuromuscular electrical stimulation in critically ill patients-a pilot study. Annals of intensive care 2013; 3(1): 1-9.
  • 26. Balas MC, Vasilevskis EE, Olsen KM, Schmid KK, Shostrom V, Cohen MZ. Effectiveness and Safety of the Awakening and Breathing Coordination, Delirium Monitoring/Management, and Early Exercise/ Mobility Bundle. Critical Care Medicine 2014; 42(5): 1024-36
  • 27. Barr J, Fraser GL, Puntillo K, Ely EW, Gélinas C, Dasta JF. Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit. Critical Care Medicine 2013; 41(1): 263-306.
  • 28. Puthucheary Z, Hart N. Intensive care unit acquired muscle weakness: when should we consider rehabilitation?. Critical Care 2009; 13(4), 1-2.
  • 29. Needham DM, Truong AD, Fan E. Technology to enhance physical rehabilitation of critically ill patients. Critical care medicine, 2009; 37(10):436-441.
  • 30. Maddocks M, Gao W, Higginson IJ, Wilcock A. Neuromuscular electrical stimulation for muscle weakness in adults with advanced disease. Cochrane Database of Systematic Reviews 2013, Issue 1. Art. No.: CD009419. DOI: 10.1002/14651858.CD009419.pub2.
  • 31. Trees D W, Smith J M, Hockert S. Innovative mobility strategies for the patient with intensive care unit– acquired weakness: a case report. Physical therapy 2013; 93(2): 237-247.
  • 32. Doiron KA, Hoffmann T, Beller EM. Early İntervention (Mobilization Or Active Exercise) For Critically Ill Patients in The İntensive Care Unit. Cochrane Database of Systematic Reviews 2013; Issue 10.
Toplam 32 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Canan Karadaş 0000-0002-3364-6276

Sevgisun Kapucu 0000-0003-3908-3846

Yayımlanma Tarihi 31 Ocak 2018
Gönderilme Tarihi 9 Kasım 2016
Yayımlandığı Sayı Yıl 2017 Cilt: 4 Sayı: 3

Kaynak Göster

Vancouver Karadaş C, Kapucu S. Son On Yılda Yoğun Bakım Ünitesi İlişkili Kas Güçsüzlüğüne Yönelik Çalışmaların İncelenmesi: Sistematik Derleme. HUHEMFAD. 2018;4(3):1-12.