Evaluating a Muscle Ultrasound Education Program: Theoretical Knowledge, Hands-on Skills, Reliability, and Satisfaction of Critical Care Physiotherapists
Date
2021
Type:
Article
item.page.extent
item.page.accessRights
item.contributor.advisor
ORCID:
Journal Title
Journal ISSN
Volume Title
Publisher
item.page.isbn
item.page.issn
item.page.issne
item.page.doiurl
item.page.other
item.page.references
Abstract
Prone positioning is a therapy utilized globally to improve gas exchange, minimize
ventilator-induced lung injury, and reduce mortality in ARDS, particularly during the ongoing coronavirus disease 2019 (COVID-19) pandemic. Whereas the respiratory benefits of prone positioning in
ARDS have been accepted, the concurrent complications could be undervalued. Therefore, this study
aimed to identify the adverse events (AEs) related to prone positioning in ARDS and, secondarily, to
collect strategies and recommendations to mitigate these AEs. METHODS: In this scoping review, we
searched recommendation documents and original studies published between June 2013 and November
2020 from 6 relevant electronic databases and the websites of intensive care societies. RESULTS: We selected 41 documents from 121 eligible documents, comprising 13 recommendation documents and 28 original studies (involving 1,578 subjects and 994 prone maneuvers). We identified > 40 individual AEs, and the highest-pooled occurrence rates were those of severe desaturation (37.9%), barotrauma (30.5%), pressure sores (29.7%), ventilation-associated pneumonia (28.2%), facial edema (16.7%), arrhythmia (15.4%), hypotension (10.2%), and peripheral nerve injuries (8.1%). The reported mitigation strategies during prone positioning included alternate face rotation (18 [43.9%]), repositioning every 2h (17 [41.5%]), and the use of pillows under the chest and pelvis (14 [34.1%]). The reported mitigation strategies for performing the prone maneuver comprised one person being at the headboard (23 [56.1%]), the use of a pre-maneuver safety checklist (18 [43.9%]), vital sign monitoring (15 [36.6%]), and ensuring appropriate ventilator settings (12 [29.3%]). CONCLUSIONS: We identified > 40 AEs
reported in prone positioning ARDS studies, including additional AEs not yet reported by previous systematic reviews. The pooled AE proportions collected in this review could guide research and clinical practice decisions, and the strategies to mitigate AEs could promote future consensus-based recommendations.
Description
item.page.coverage.spatial
item.page.sponsorship
Citation
González-Seguel F, Pinto-Concha JJ, Ríos-Castro F, Silva-Gutiérrez A, Camus-Molina A, Mayer KP, Parry SM. Evaluating a Muscle Ultrasound Education Program: Theoretical Knowledge, Hands-on Skills, Reliability, and Satisfaction of Critical Care Physiotherapists. Arch Rehabil Res Clin Transl. 2021 Jul 13;3(3):100142. doi: 10.1016/j.arrct.2021.100142.
Keywords
coefficient of variation, Critical care, Education, ICC, intraclass correlation coefficient, ICU, Intensive care unit, nterquartile range, IQR, Knowledge assessment, Muscle ultrasound, Muscular atrophy, Pennation angle, Physiotherapy, QC, Quadriceps complex, Rectus femoris, Rehabilitation, Standard error of measurement, Ultrasonography, Vastus intermedius, VL, Vastus lateralis