Annals of the American Thoracic Society
-
Background: Survivors of critical illness may experience physical-function deficits after intensive care unit (ICU) discharge. In-ICU cycle ergometry may facilitate early mobilization and decrease functional impairment. Objective: We conducted a systematic review and meta-analysis to understand the effect of in-ICU leg-cycle ergometry on patient-important and clinically relevant outcomes. ⋯ The adverse event rate in cycling sessions was 0.16% across studies (10 studies; 5 of 3,117 sessions; very low certainty). Conclusions: Cycling initiated in the ICU is probably safe; however, we did not find any differences in physical function, MV duration, LOS, QoL, or mortality compared with those not receiving cycling. Rigorously designed RCTs are needed to improve precision and further investigate the effect of cycling on patient-important outcomes.
-
Rationale: Diaphragm function is a key determinant of dyspnea in chronic obstructive pulmonary disease (COPD); however, it is rarely assessed in clinical practice. Lung hyperinflation can also impair diaphragm function. Ultrasound can assess the activity, function, and force reserve of the diaphragm. ⋯ Ultrasound assessment of the diaphragm in COPD provides important functional information. Clinical trial registered with the Thai Clinical Trials Registry (TCTR20160411001). Registered 31 April 5, 2016.