[SY1-1] Recent updates on safety and feasibility of rehabilitation and mobilization of critically ill adults
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Dr. Needham is Professor of Pulmonary and Critical Care Medicine, and of Physical Medicine and Rehabilitation at the Johns Hopkins University in Baltimore, USA. He is Director of the “Outcomes After Critical Illness and Surgery” (OACIS) Research Group and core faculty with the Armstrong Institute for Patient Safety and Quality, both at Johns Hopkins. From a clinical perspective, he is an attending physician in the medical intensive care unit at Johns Hopkins Hospital and Medical Director of the Johns Hopkins Critical Care Physical Medicine and Rehabilitation program.
Dr. Needham received his MD degree from McMaster University in Hamilton, Canada, and completed both his residency in internal medicine and his fellowship in critical care medicine at the University of Toronto. He obtained his PhD in Clinical Investigation from the Bloomberg School of Public Health at Johns Hopkins University. Notably, prior to his medical training, he completed Bachelor and Master degrees in Accounting and practiced in a large international accounting firm, with a focus in the health care field.
Dr. Needham is Principal Investigator on a number of NIH research grants and has authored more than 350 publications. His research interests include evaluating and improving ICU patients’ long-term physical, cognitive and mental health outcomes, including research in the areas of sedation, delirium, early physical rehabilitation, and knowledge translation and quality improvement.
Up to 50% of intensive care unit (ICU) survivors experience ICU-Acquired Weakness (ICUAW). Immobility is an important and modifiable risk factor for ICUAW and associated long-term impairments in physical functioning. Early rehabilitation and mobilization in the ICU are important considerations for addressing these post-ICU sequelae.
The 2013 Society of Critical Care Medicine (SCCM) Pain, Agitation, and Delirium (PAD) guidelines suggested that rehabilitation and mobilization in the ICU may have a beneficial effect for delirium in the ICU (Crit Care Med 2013; 41:263–306). In the 2018 SCCM Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption (PADIS) guidelines, immobility was added as a unique area of focus. The Immobility section of the 2018 PADIS guidelines is based on a comprehensive assessment of the available evidence addressing issues related to the efficacy, safety, and implementation of rehabilitation and mobility in the ICU. These PADIS guidelines were rigorously developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) technique and involving ICU survivors as collaborators in every step of the process.
This presentation will discuss the rehabilitation and mobility aspects of the 2018 PADIS guidelines along with updates from the most recent clinical research studies evaluating rehabilitation and mobilization in the ICU. This presentation also will discuss future considerations for this field of research and clinical practice.
Free access to the full-text of four publications related to the 2018 SCCM PADIS guidelines is available at this webpage:
http://www.sccm.org/ICULiberation/Guidelines
The 2013 Society of Critical Care Medicine (SCCM) Pain, Agitation, and Delirium (PAD) guidelines suggested that rehabilitation and mobilization in the ICU may have a beneficial effect for delirium in the ICU (Crit Care Med 2013; 41:263–306). In the 2018 SCCM Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption (PADIS) guidelines, immobility was added as a unique area of focus. The Immobility section of the 2018 PADIS guidelines is based on a comprehensive assessment of the available evidence addressing issues related to the efficacy, safety, and implementation of rehabilitation and mobility in the ICU. These PADIS guidelines were rigorously developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) technique and involving ICU survivors as collaborators in every step of the process.
This presentation will discuss the rehabilitation and mobility aspects of the 2018 PADIS guidelines along with updates from the most recent clinical research studies evaluating rehabilitation and mobilization in the ICU. This presentation also will discuss future considerations for this field of research and clinical practice.
Free access to the full-text of four publications related to the 2018 SCCM PADIS guidelines is available at this webpage:
http://www.sccm.org/ICULiberation/Guidelines