Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Annals of Intensive Care
Published in: Annals of Intensive Care 1/2022

Open Access 01-12-2022 | Dyspnea | Research

Corporeal rehabilitation to manage acute stress in critically ill patients

Authors: Irma Bourgeon-Ghittori, Maryline Couette, Sylvie Marini, Rachida Ouedraogo, Aline Alves, Keyvan Razazi, Damien Carras, Ann-Cecile Pallud, Nancy Kentish-Barnes, Armand Mekontso Dessap

Published in: Annals of Intensive Care | Issue 1/2022

Login to get access

Abstract

Background

Intensive care unit (ICU) patients often endure discomfort and distress brought about by their medical environment and the subjective experience of their stay. Distress, pain, and loss of control are important predictors of future neuropsychiatric disorders. Depression, anxiety, and post-traumatic stress are common after discharge. We aimed at mitigating acute stress and discomfort via a novel intervention based on body image rehabilitation and rehabilitation of senses performed following a holistic approach guided by positive communication (corporeal rehabilitation care, CRC).

Results

We conducted a prospective observational study on 297 consecutively enrolled patients participating in at least one CRC session. Benefits of CRC were assessed on both subjective analogical scales of stress, pain, and well-being criteria, and objective clinical measures of dyspnea, respiratory rate, and systolic arterial pressure, just after CRC and long after (a median of 72 min later) to estimate its remote effect. Results showed that CRC had a positive effect on all overt measures of distress (acute stress, pain, discomfort) just after CRC and remotely. This beneficial effect was also observed on dyspnea and respiratory rate. Results also showed that best CRC responders had higher baseline values of stress and heart rate and lower baseline values of well-being score, indicating that the care targeted the population most at risk of developing psychological sequelae. Interestingly, a positive CRC response was associated with a better survival even after adjustment for physiologic severity, indicating a potential to identify patients prompt to better respond to other therapeutics and/or rehabilitation.

Conclusion

This study demonstrated the feasibility of an innovative holistic patient-centered care approach and its short-term positive effects on critical parameters that are considered risk factors for post-intensive care syndrome. Further studies are warranted to study long-term benefits for patients, and overall benefits for relatives as well as ICU staff.
Literature
1.
Novaes MAFP, Aronovich A, Ferraz MB, Knobel E. Stressors in ICU: patients’ evaluation. Intensive Care Med. 1997;23:1282–5.PubMedCrossRef
2.
Rotondi AJ, Chelluri L, Sirio C, Mendelsohn A, Schulz R, Belle S, et al. Patients’ recollections of stressful experiences while receiving prolonged mechanical ventilation in an intensive care unit*. Crit Care Med. 2002;30:746–52.PubMedCrossRef
3.
4.
van de Leur JP, van der Schans CP, Loef BG, Deelman BG, Geertzen JH, Zwaveling JH. Discomfort and factual recollection in intensive care unit patients. Crit Care. 2004;8:R467.PubMedPubMedCentralCrossRef
5.
6.
Kalfon P, Mimoz O, Loundou A, Geantot M-A, Revel N, Villard I, et al. Reduction of self-perceived discomforts in critically ill patients in French intensive care units: study protocol for a cluster-randomized controlled trial. Trials. 2016;17:87.PubMedPubMedCentralCrossRef
7.
Chlan LL, Engeland WC, Savik K. Does music influence stress in mechanically ventilated patients? Intensive Crit Care Nurs. 2013;29:121–7.PubMedCrossRef
8.
Chlan LL, Weinert CR, Heiderscheit A, Tracy MF, Skaar DJ, Guttormson JL, et al. Effects of patient-directed music intervention on anxiety and sedative exposure in critically ill patients receiving mechanical ventilatory support: a randomized clinical trial. JAMA. 2013;309:2335–44.PubMedPubMedCentralCrossRef
9.
Tracy MF, Chlan L, Staugaitis A. Perceptions of patients and families who received a music intervention during mechanical ventilation. Music Med. 2015;7:54–8.PubMedPubMedCentralCrossRef
10.
Hayes J, Cox C. Immediate effects of a five-minute foot massage on patients in critical care. Intensive Crit Care Nurs. 1999;15:77–82.PubMedCrossRef
11.
Blanke O. Multisensory brain mechanisms of bodily self-consciousness. Nat Rev Neurosci. 2012;13:556–71.PubMedCrossRef
12.
Craig ADB. Significance of the insula for the evolution of human awareness of feelings from the body. Ann N Y Acad Sci. 2011;1225:72–82.PubMedCrossRef
13.
Karnath H-O, Baier B. Right insula for our sense of limb ownership and self-awareness of actions. Brain Struct Funct. 2010;214:411–7.PubMedCrossRef
14.
15.
Serino A, Alsmith A, Costantini M, Mandrigin A, Tajadura-Jimenez A, Lopez C. Bodily ownership and self-location: components of bodily self-consciousness. Conscious Cogn. 2013;22:1239–52.PubMedCrossRef
16.
Brown EN, Purdon PL, Van Dort CJ. General anesthesia and altered states of arousal: a systems neuroscience analysis. Annu Rev Neurosci. 2011;34:601–28.PubMedPubMedCentralCrossRef
17.
Moody OA, Zhang ER, Vincent KF, Kato R, Melonakos ED, Nehs CJ, et al. The neural circuits underlying general anesthesia and sleep. Anesth Analg. 2021;132:1254–64.PubMedPubMedCentralCrossRef
18.
Sessler CN, Gosnell MS, Grap MJ, Brophy GM, O’Neal PV, Keane KA, et al. The Richmond agitation-sedation scale: validity and reliability in adult intensive care unit patients. Am J Respir Crit Care Med. 2002;166:1338–44.PubMedCrossRef
19.
20.
Karcioglu O, Topacoglu H, Dikme O, Dikme O. A systematic review of the pain scales in adults: Which to use? Am J Emerg Med. 2018;36:707–14.PubMedCrossRef
21.
Campbell ML. Psychometric testing of a respiratory distress observation scale. J Palliat Med. 2008;11:44–50.PubMedCrossRef
22.
Campbell ML, Templin T, Walch J. A Respiratory Distress Observation Scale for patients unable to self-report dyspnea. J Palliat Med. 2010;13:285–90.PubMedCrossRef
23.
Persichini R, Gay F, Schmidt M, Mayaux J, Demoule A, Morélot-Panzini C, et al. Diagnostic accuracy of respiratory distress observation scales as surrogates of dyspnea self-report in intensive care unit patients. Anesthesiology. 2015;123:830–7.PubMedCrossRef
24.
Todres L, Galvin K, Holloway I. The humanization of healthcare: a value framework for qualitative research. Int J Qual Stud Health Well-Being. 2009;4:68–77.CrossRef
25.
Jakimowicz S, Perry L, Lewis J. Insights on compassion and patient-centred nursing in intensive care: a constructivist grounded theory. J Clin Nurs. 2018;27:1599–611.PubMedCrossRef
26.
Kim H-G, Cheon E-J, Bai D-S, Lee YH, Koo B-H. Stress and heart rate variability: a meta-analysis and review of the literature. Psychiatry Investig. 2018;15:235–45.PubMedPubMedCentralCrossRef
27.
Thayer JF, Åhs F, Fredrikson M, Sollers JJ, Wager TD. A meta-analysis of heart rate variability and neuroimaging studies: implications for heart rate variability as a marker of stress and health. Neurosci Biobehav Rev. 2012;36:747–56.PubMedCrossRef
28.
Morris MC, Hellman N, Abelson JL, Rao U. Cortisol, heart rate, and blood pressure as early markers of PTSD risk: a systematic review and meta-analysis. Clin Psychol Rev. 2016;49:79–91.PubMedPubMedCentralCrossRef
29.
30.
Porges SW. Orienting in a defensive world: mammalian modifications of our evolutionary heritage. A polyvagal theory. Psychophysiology. 1995;32:301–18.PubMedCrossRef
31.
32.
Cupit-Link M, Syrjala KL, Hashmi SK. Damocles’ syndrome revisited: update on the fear of cancer recurrence in the complex world of today’s treatments and survivorship. Hematol Oncol Stem Cell Ther. 2018;11:129–34.PubMedPubMedCentralCrossRef
33.
Alabdaljabar MS, Muhsen IN, Knight JM, Syrjala KL, Hashmi SK. Free of malignancy but not of fears: a closer look at Damocles syndrome in survivors of hematologic malignancies. Blood Rev. 2021;48:100783.PubMedCrossRef
34.
Inoue S, Hatakeyama J, Kondo Y, Hifumi T, Sakuramoto H, Kawasaki T, et al. Post-intensive care syndrome: its pathophysiology, prevention, and future directions. Acute Med Surg. 2019;6:233–46.PubMedPubMedCentralCrossRef
35.
Yuan C, Timmins F, Thompson DR. Post-intensive care syndrome: a concept analysis. Int J Nurs Stud. 2021;114:103814.PubMedCrossRef
36.
Righy C, Rosa RG, da Silva RTA, Kochhann R, Migliavaca CB, Robinson CC, et al. Prevalence of post-traumatic stress disorder symptoms in adult critical care survivors: a systematic review and meta-analysis. Crit Care. 2019;23:213.PubMedPubMedCentralCrossRef
37.
Nikayin S, Rabiee A, Hashem MD, Huang M, Bienvenu OJ, Turnbull AE, et al. Anxiety symptoms in survivors of critical illness: a systematic review and meta-analysis. Gen Hosp Psychiatry. 2016;43:23–9.PubMedPubMedCentralCrossRef
38.
Davydow DS, Gifford JM, Desai SV, Bienvenu OJ, Needham DM. Depression in general intensive care unit survivors: a systematic review. Intensive Care Med. 2009;35:796–809.PubMedCrossRef
39.
Adam EK, Quinn ME, Tavernier R, McQuillan MT, Dahlke KA, Gilbert KE. Diurnal cortisol slopes and mental and physical health outcomes: a systematic review and meta-analysis. Psychoneuroendocrinology. 2017;83:25–41.PubMedPubMedCentralCrossRef
40.
De Hert M, Detraux J, Vancampfort D. The intriguing relationship between coronary heart disease and mental disorders. Dialogues Clin Neurosci. 2018;20:31–40.PubMedPubMedCentralCrossRef
41.
Marsland AL, Walsh C, Lockwood K, John-Henderson NA. The effects of acute psychological stress on circulating and stimulated inflammatory markers: a systematic review and meta-analysis. Brain Behav Immun. 2017;64:208–19.PubMedPubMedCentralCrossRef
42.
Pacella ML, Hruska B, Delahanty DL. The physical health consequences of PTSD and PTSD symptoms: a meta-analytic review. J Anxiety Disord. 2013;27:33–46.PubMedCrossRef
43.
44.
Sher L. Type D personality: the heart, stress, and cortisol. QJM Mon J Assoc Physicians. 2005;98:323–9.CrossRef
45.
Jagan S, Park T, Papathanassoglou E. Effects of massage on outcomes of adult intensive care unit patients: a systematic review. Nurs Crit Care. 2019;24:414–29.PubMedCrossRef
46.
Rozanski A, Bavishi C, Kubzansky LD, Cohen R. Association of optimism with cardiovascular events and all-cause mortality: a systematic review and meta-analysis. JAMA Netw Open. 2019;2:e1912200.PubMedPubMedCentralCrossRef
47.
Rasmussen HN, Scheier MF, Greenhouse JB. Optimism and physical health: a meta-analytic review. Ann Behav Med Publ Soc Behav Med. 2009;37:239–56.CrossRef
Metadata
Title
Corporeal rehabilitation to manage acute stress in critically ill patients
Authors
Irma Bourgeon-Ghittori
Maryline Couette
Sylvie Marini
Rachida Ouedraogo
Aline Alves
Keyvan Razazi
Damien Carras
Ann-Cecile Pallud
Nancy Kentish-Barnes
Armand Mekontso Dessap
Publication date
01-12-2022
Publisher
Springer International Publishing
Keywords
Dyspnea
Dyspnea
Published in
Annals of Intensive Care / Issue 1/2022
Electronic ISSN: 2110-5820
DOI
https://doi.org/10.1186/s13613-022-01019-3

Other articles of this Issue 1/2022

Annals of Intensive Care 1/2022 Go to the issue

Research

Dyspnea and the electromyographic activity of inspiratory muscles during weaning from mechanical ventilation

Research

Abdominal atherosclerosis is not a risk factor of nonocclusive mesenteric ischemia among critically ill patients: a propensity matching study

Review

Use of dexmedetomidine in patients with sepsis: a systematic review and meta-analysis of randomized-controlled trials

Research

Impaired skin microvascular endothelial reactivity in critically ill COVID-19 patients

Research

Risk factors for peripheral intravascular catheter-related phlebitis in critically ill patients: analysis of 3429 catheters from 23 Japanese intensive care units

Research

Severe but reversible impaired diaphragm function in septic mechanically ventilated patients