Physiotherapy Rehabilitation Following a Stay in ICU Essay

physiotherapy rehabilitation following a stay in ICU

A stay in the Intensive care unit can be a set back to the full recovery of a patient calling for a need to carry out a rehabilitation program. According to Bersten, Soni, & Oh (2009), after a patient is discharged from the intensive care unit, there is requirement for a care plan that is multidisciplinary in order to achieve the best possible recovery for the patient. No matter the rehabilitation program that health care providers may choose to adopt, prior assessment of the patient is critical to help them in making the most informed decisions on the appropriate approach to apply (Porter, and Tidy, 2008). This paper will look at the evidence of an aged patient who developed sepsis after a surgery to remove bowel.

Most patients that recover from long-term sepsis are able to regain normalcy in life. However, some patients may suffer from long-term effects that include permanent organ damage. Some evidence indicates that the occurrence of severe sepsis may destabilize the immune system of a patient. The susceptibility of elderly patients to inflammatory infections necessitates the exercise of care so that any infection that might cause sepsis be curtailed.

Reintroduction of gravitational force helps in improving oxygen transport particularly in patients that are critically ill. The loss of function in critically sick patients that presents itself in form of poor muscle protein synthesis, poor microvascular functions and diaphragmatic dysfunction can be cured through the application of a well structured therapy program that will help in their recovery and as thus rehabilitation should start as soon as possible (Baudouin, 2008).

Main theory

Corticosteroids are said to be very important in the treatment of septic shock and sepsis in general. The therapeutic role of this treatment stemmed from the theory that an exaggerated host infection, which is usually inflammatory, often result from a case of septic shock or severe sepsis. Sepsis is formally defined as an inflammatory response syndrome that is systematic in nature, and may present itself in form of symptoms that include leukocytosis, tachypnea, fever and tachycardia.Clinically observed infections may include community acquired pneumonia, infected wound oozing pus or in worst case scenarios a bowel that is ruptured to the point that it exposes its contents in the peritoneum (Gao, Melody, Daniels, Giles, Fox 2005).

The grading system for sepsis has since been modified to encompass septic shock, severe sepsis and refractory septic shock. In addition to the aforementioned clinical symptoms, severe sepsis may also include a sign of organ hypoperfusion. Patients with sepsis infection will require assistance to carry out their daily activities. Simple daily activities that include walking and dressing may look simple to a healthy man but not a healthy man. This is not the case in a patient with sepsis. These patients are often found to suffer from reduced strength, loss of muscle mass and a decline in the number of mitochondria (Gao et al. 2005). Such patients are often advised to take sufficient bed rest.

Examples of evidence

Some contradicting evidence from a study conducted by a critical care expert at the John Hopkins Hospital indicate; long-term sedation and prolonged bed rest may be resulting into a delay in physical recovery, and may also afford the patients some poor quality life upon discharge. Looking at an earlier case of critically injured patients in World War II, moving these patients around proved to be the best physiotherapy remedy as opposed to confining them to prolonged bed rest. Early mobilization is the desired mode of treatment. However, this should be done in a planned fashion so as to avoid over doing it.

Alternate theory

An alternate theory points at adrenal insufficiency as the main challenge for severe patients Sepsis develop when inflammations occur. This inflammation is accompanied by worsening physical and cognitive functions. Adrenal insufficiency causes some physical enervation, a condition that necessitates physiotherapy. Patients need to be exposed to exercises that will help them avoid or reduce the challenges that accompany the adrenal insufficiency condition.

Evidence

Low….....