Functional and cognitive rehabilitation interventions during intensive care admission: A protocol for a systematic integrative review

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Long-term cognitive impairment occurs in up to 60% of intensive care unit (ICU) survivors. Early use of functional and cognitive rehabilitation interventions, while patients are still in ICU, may reduce cognitive decline. We aim to describe the functional and cognitive interventions used during the ICU stay, the healthcare professionals providing interventions, and the potential impact on functional and cognitive rehabilitation.

In this integrative systematic review, we will include empirical qualitative, quantitative, mixed- and multiple-methods studies assessing the use of functional and cognitive rehabilitation provided in ICU. We will identify studies in relevant electronic databases from 2012 to 2022, which will be screened for eligibility by at least two reviewers. Literature reported as narrative reviews and editorials will be excluded. We will assess the impact of interventions evaluating a cognitive and functional function, quality of life, and all-cause mortality at 6–12 months after ICU discharge. The Revised Cochrane risk-of-bias Tool will be used for assessing risk of bias in clinical trials. For observational studies, we will use the National Institutes of Health Quality Assessment tool for Observational Cohort and Cross-Sectional Studies. Furthermore, we will use the critical appraisal skills programme for qualitative studies and the mixed methods appraisal tool for mixed methods studies. We will construct four matrices, including results describing which ICU patients and healthcare professionals were engaged in rehabilitation, which interventions were included in early rehabilitation in ICU, the potential impact on patient outcomes of rehabilitation interventions provided in ICU and a narrative synthesis of themes. A summary of the main results will be reported using modified GRADE methodology.

This integrative review will inform the feasibility randomised clinical trial testing the development of a complex intervention targeting functional and cognitive rehabilitation for patients in ICU.
TidsskriftActa Anaesthesiologica Scandinavica
Udgave nummer5
Sider (fra-til)670-674
Antal sider5
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
The Department of Intensive Care at Rigshospitalet has received funding for other projects from the Novo Nordisk Foundation, Pfizer, Fresenius Kabi, Sygeforsikringen ‘Danmark’, Ehrenreich's Foundation, Dagmar Marshalls Fond and conducted contract research for AM‐Pharma.

Funding Information:
This study was conducted as part of the Nurse‐Led early functional and cognitive Stimulation to prevent long‐term adverse outcomes in Intensive Care patients (NLS‐ICU) research program funded by the Novo Nordisk Foundation and the Lundbeck Foundation.

Funding Information:
The study is funded by the Novo Nordisk foundation (NNF21OC0072048). The foundation was not involved in designing and reporting this manuscript.

Publisher Copyright:
© 2023 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

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