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Improving post-intensive care unit neuropsychiatric outcomes: understanding cognitive effects of physical activity.

Publication ,  Journal Article
Hopkins, RO; Suchyta, MR; Farrer, TJ; Needham, D
Published in: American journal of respiratory and critical care medicine
December 2012

Critical illness and its treatment often result in long-term neuropsychiatric morbidities. Consequently, there is a need to focus on means to prevent or ameliorate these morbidities. Animal models provide important data regarding the neurobiological effects of physical activity, including angiogenesis, neurogenesis, and release of neurotrophic factors that enhance plasticity. Studies in noncritically ill patients demonstrate that exercise is associated with increased cerebral blood flow, neurogenesis, and brain volume, which are associated with improved cognition. Clinically, research in both healthy and diseased human subjects suggests that exercise improves neuropsychiatric outcomes. In the critical care setting, early physical rehabilitation and mobilization are safe and feasible, with demonstrated improvements in physical functional outcomes. Such activity may also reduce the duration of delirium in the intensive care unit (ICU) and improve neuropsychiatric outcomes, although data are limited. Barriers exist regarding implementing ICU rehabilitation in routine care, including use of sedatives and lack of awareness of post-ICU cognitive impairments. Further research is necessary to determine whether prior animal and human research, in conjunction with preliminary results from existing ICU studies, can translate into improvements for neuropsychiatric outcomes in critically ill patients. Studies are needed to evaluate biological mechanisms, risk factors, the role of pre-ICU functional level, and the timing, duration, and type of physical activity for optimal patient outcomes.

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Published In

American journal of respiratory and critical care medicine

DOI

EISSN

1535-4970

ISSN

1073-449X

Publication Date

December 2012

Volume

186

Issue

12

Start / End Page

1220 / 1228

Related Subject Headings

  • Respiratory System
  • Rats
  • Quality Improvement
  • Primates
  • Patient Discharge
  • Neurogenesis
  • Intensive Care Units
  • Humans
  • Exercise
  • Disease Models, Animal
 

Citation

APA
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ICMJE
MLA
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Hopkins, R. O., Suchyta, M. R., Farrer, T. J., & Needham, D. (2012). Improving post-intensive care unit neuropsychiatric outcomes: understanding cognitive effects of physical activity. American Journal of Respiratory and Critical Care Medicine, 186(12), 1220–1228. https://doi.org/10.1164/rccm.201206-1022cp
Hopkins, Ramona O., Mary R. Suchyta, Thomas J. Farrer, and Dale Needham. “Improving post-intensive care unit neuropsychiatric outcomes: understanding cognitive effects of physical activity.American Journal of Respiratory and Critical Care Medicine 186, no. 12 (December 2012): 1220–28. https://doi.org/10.1164/rccm.201206-1022cp.
Hopkins RO, Suchyta MR, Farrer TJ, Needham D. Improving post-intensive care unit neuropsychiatric outcomes: understanding cognitive effects of physical activity. American journal of respiratory and critical care medicine. 2012 Dec;186(12):1220–8.
Hopkins, Ramona O., et al. “Improving post-intensive care unit neuropsychiatric outcomes: understanding cognitive effects of physical activity.American Journal of Respiratory and Critical Care Medicine, vol. 186, no. 12, Dec. 2012, pp. 1220–28. Epmc, doi:10.1164/rccm.201206-1022cp.
Hopkins RO, Suchyta MR, Farrer TJ, Needham D. Improving post-intensive care unit neuropsychiatric outcomes: understanding cognitive effects of physical activity. American journal of respiratory and critical care medicine. 2012 Dec;186(12):1220–1228.

Published In

American journal of respiratory and critical care medicine

DOI

EISSN

1535-4970

ISSN

1073-449X

Publication Date

December 2012

Volume

186

Issue

12

Start / End Page

1220 / 1228

Related Subject Headings

  • Respiratory System
  • Rats
  • Quality Improvement
  • Primates
  • Patient Discharge
  • Neurogenesis
  • Intensive Care Units
  • Humans
  • Exercise
  • Disease Models, Animal