Early Rehabilitation in adult and paediatric critically ill patients with respiratory failure, sepsis, and pneumonia: Case series
Abstract
Background: Critically ill patients with acute respiratory failure,sepsis, pneumonia,and complex comorbidities frequently develop prolonged ventilator dependence,impaired airway clearance, intensive care unit-acquired weakness (ICU-AW), anda high risk oof post-intensive care syndrome (PICS). Early, structured rehabilitationthat integrates respiratory support, neuromuscular preservation, and mobilizationmay improve recovery.
Case: This case series describes three patients treated in the adult ICU andpediatric ICU of Persahabatan General Hospital's who received individualizedintensive rehabilitation. A young adult with obesity, type 2 diabetes and sepsis; amiddle-aged adult with severe community-acquired pneumonia and prolongedmechanical ventilation; and a preschool child with status epilepticus, sepsis, andbronchopneumonia. Functional status was evaluated using ICU Mobility Scale(IMS), Chelsea Critical Care Physical Assessment Tool (CPAx), Medical ResearchCouncil Sum Score (MRC-SS), Functional Status Scale (FSS), and grip strength.After 2 weeks, case 1 showed IMS improving from 0 to 6, CPAx from 2 to 27, andMRC-SS from 40 to 60, alongside successful ventilator weaning. After 3 weeks,case 2 showed CPAx improving from 5 to 20, IMS from 1 to 4, MRC-SS from 24to 32, grip strength from 5.2 to 11.3 kg in both arms, and cough flow from 45 to 79L/min. Case 3 showed FSS improving from 23/36 to 16/36 and IMS from 0 to 6after 3 weeks.
Discussion: These cases illustrate the feasibility…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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