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Risk Factors for Physical Impairment after Acute Lung Injury in a National, Multicenter Study

NEEDHAM, Dale M ; WOZNIAK, Amy W ; HOPKINS, Ramona O ; HOUGH, Catherine L ; MORRIS, Peter E ; DINGLAS, Victor D ; JACKSON, James C ; MENDEZ-TELLEZ, Pedro A ; SHANHOLTZ, Carl ; ELY, E. Wesley ; COLANTUONI, Elizabeth

American journal of respiratory and critical care medicine, 2014-05, Vol.189 (10), p.1214-1224 [Periódico revisado por pares]

New York, NY: American Thoracic Society

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Título:
Risk Factors for Physical Impairment after Acute Lung Injury in a National, Multicenter Study
Autor: NEEDHAM, Dale M ; WOZNIAK, Amy W ; HOPKINS, Ramona O ; HOUGH, Catherine L ; MORRIS, Peter E ; DINGLAS, Victor D ; JACKSON, James C ; MENDEZ-TELLEZ, Pedro A ; SHANHOLTZ, Carl ; ELY, E. Wesley ; COLANTUONI, Elizabeth
Assuntos: Acute Lung Injury - complications ; Acute Lung Injury - drug therapy ; Acute Lung Injury - mortality ; Acute Lung Injury - physiopathology ; Adult ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Drug Therapy, Combination ; Exercise Test - methods ; Female ; Follow-Up Studies ; Glucocorticoids - adverse effects ; Glucocorticoids - therapeutic use ; Humans ; Intensive care medicine ; Intensive Care Units ; Length of Stay ; Longitudinal Studies ; Male ; Medical sciences ; Middle Aged ; Muscle Strength - drug effects ; Muscle Weakness - etiology ; Neuromuscular Blocking Agents - adverse effects ; Neuromuscular Blocking Agents - therapeutic use ; Original ; Pneumology ; Prospective Studies ; Quality of Life ; Respiratory Distress Syndrome, Adult - complications ; Respiratory Distress Syndrome, Adult - drug therapy ; Respiratory Distress Syndrome, Adult - mortality ; Respiratory Distress Syndrome, Adult - physiopathology ; Risk Factors ; United States ; Walking
É parte de: American journal of respiratory and critical care medicine, 2014-05, Vol.189 (10), p.1214-1224
Notas: A list of members of the NIH NHLBI ARDS Network may be found before the beginning of the References.
Descrição: Existing studies of risk factors for physical impairments in acute lung injury (ALI) survivors were potentially limited by single-center design or relatively small sample size. To evaluate risk factors for three measures of physical impairments commonly experienced by survivors of ALI in the first year after hospitalization. A prospective, longitudinal study of 6- and 12-month physical outcomes (muscle strength, 6-minute-walk distance, and Short Form [SF]-36 Physical Function score) for 203 survivors of ALI enrolled from 12 hospitals participating in the ARDS Network randomized trials. Multivariable regression analyses evaluated the independent association of critical illness-related variables and intensive care interventions with impairments in each physical outcome measure, after adjusting for patient demographics, comorbidities, and baseline functional status. At 6 and 12 months, respectively, mean (± SD) values for strength (presented as proportion of maximum strength score evaluated using manual muscle testing) was 92% (± 8%) and 93% (± 9%), 6-minute-walk distance (as percent-predicted) was 64% (± 22%) and 67% (± 26%), and SF-36 Physical Function score (as percent-predicted) was 61% (± 36%) and 67% (± 37%). After accounting for patient baseline status, there was significant association and statistical interaction of mean daily dose of corticosteroids and intensive care unit length of stay with impairments in physical outcomes. Patients had substantial impairments, from predicted values, for 6-minute-walk distance and SF-36 Physical Function outcome measures. Minimizing corticosteroid dose and implementing existing evidence-based methods to reduce duration of intensive care unit stay and associated patient immobilization may be important interventions for improving ALI survivors' physical outcomes.
Editor: New York, NY: American Thoracic Society
Idioma: Inglês

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Risk Factors for Physical Impairment after Acute Lung Injury in a National, Multicenter Study

NEEDHAM, Dale M ; WOZNIAK, Amy W ; HOPKINS, Ramona O ; HOUGH, Catherine L ; MORRIS, Peter E ; DINGLAS, Victor D ; JACKSON, James C ; MENDEZ-TELLEZ, Pedro A ; SHANHOLTZ, Carl ; ELY, E. Wesley ; COLANTUONI, Elizabeth

New York, NY: American Thoracic Society

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