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Activity Helps Intensive Care Patients’ Functional Outcomes

Last Updated: May 14, 2009.

Patients in the intensive care unit return to normal functioning faster when their sedation is interrupted daily by periods of physical activity, according to a study in the May 14 The Lancet.

THURSDAY, May 14 (HealthDay News) -- Patients in the intensive care unit (ICU) return to normal functioning faster when their sedation is interrupted daily by periods of physical activity, according to a study in the May 14 issue of The Lancet.

William D. Schweickert, M.D., of the University of Pennsylvania in Philadelphia, and colleagues randomly assigned 104 sedated and ventilated patients in the ICU to either daily interruption of sedation with physical and occupational therapy or to standard care as ordered by the patient's care team. The primary endpoint was functional status at hospital discharge, defined as walking independently and being able to carry out daily living activities.

The researchers found that 29 (59 percent) patients in the intervention group achieved independent functional status at discharge compared to 19 (35 percent) patients in the control group. Patients in the intervention group also had shorter periods of delirium (median 2.0 versus 4.0 days) and more days off the ventilator (23.5 versus 21.1 days). The investigators further note that in 498 therapy sessions, there was one serious adverse event in the intervention group (desaturation less than 80 percent), and patient instability occurred in 19 sessions (4 percent), most commonly patient-ventilator asynchrony.

"A strategy for whole-body rehabilitation -- consisting of interruption of sedation and physical and occupational therapy in the earliest days of critical illness -- was safe and well tolerated, and resulted in better functional outcomes at hospital discharge, a shorter duration of delirium, and more ventilator-free days compared with standard care," the authors write.

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