***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The aim of this study was to investigate the effects of mobilisation on respiratory and haemodynamic variables in the intubated , ventilated abdominal surgical patient .  Mobilisation was defined as the progression of activity from supine , to sitting over the edge of the bed , st and ing , walking on the spot for one minute , sitting out of bed initially , and sitting out of bed for 20 minutes . Seventeen patients with age ( mean + /- SD ) 71.4 + /- 7.1 years satisfied inclusion criteria .  Respiratory and haemodynamic parameters were measured in each of the above positions and compared with supine . In the 15 subjects who completed the protocol , st and ing result ed in significant increases in minute ventilation ( VE ) from 15.1 + /- 3.1 l/min in supine to 21.3 + /- 3.6 l/min in st and ing ( p < 0.001 ) . The increase in VE in st and ing was achieved by significant increases in tidal volume ( VT ) from 712.7 + /- 172.8 ml to 883.4 + /- 196.3 ml ( p = 0.008 ) and in respiratory rate ( fR ) from 21.4 + /- 5.0 breaths/min to 24.9 + /- 4.5 breaths/min ( p = 0.03 ) . No further increases were observed in these parameters beyond st and ing when activity was progressed to walking on the spot for one minute . When supine values were compared with walking on the spot for one minute , inspiratory flow rates ( VT/TI ) increased significantly from 683 + /- 131.8 ml/sec to 985.1 + /- 162.3 ml/sec ( p = 0.001 ) with significant increases in rib cage displacement ( p = 0.001 ) and no significant increase in abdominal displacement ( p = 0.23 ) . Arterial blood gases displayed no improvements following mobilisation . Changes in VT , fR , and VE were largely due to positional changes when moving from supine to st and ing Objective : To determine whether early activity is feasible and safe in respiratory failure patients . Design : Prospect i ve cohort study . Setting : From June 1 , 2003 , through December 31 , 2003 , we assessed safety and feasibility of early activity in all consecutive respiratory failure patients who required mechanical ventilation for > 4 days admitted to our respiratory intensive care unit ( RICU ) . A majority of patients were treated in another intensive care unit ( ICU ) before RICU admission . We excluded patients who required mechanical ventilation for ≤4 days . Patients : Eight‐bed RICU at LDS Hospital . Interventions : We assessed patients for early activity as part of routine respiratory ICU care . We prospect ively recorded activity events and adverse events . We defined three activity events as sit on bed , sit in chair , and ambulate . We defined six activity‐related adverse events as fall to knees , tube removal , systolic blood pressure > 200 mm Hg , systolic blood pressure < 90 mm Hg , oxygen desaturation < 80 % , and extubation . Measurements and Main Results : During the study period , we conducted a total of 1,449 activity events in 103 patients . The activity events included 233 ( 16 % ) sit on bed , 454 ( 31 % ) sit in chair , and 762 ( 53 % ) ambulate . In patients with an endotracheal tube in place , there were a total of 593 activity events , of which 249 ( 42 % ) were ambulation . There were < 1 % activity‐related adverse events , including fall to the knees without injury , feeding tube removal , systolic blood pressure > 200 mm Hg , systolic blood pressure < 90 mm Hg , and desaturation < 80 % . No patient was extubated during activity . Conclusions : We conclude that early activity is feasible and safe in respiratory failure patients . A majority of survivors ( 69 % ) were able to ambulate > 100 feet at RICU discharge . Early activity is a c and i date therapy to prevent or treat the neuromuscular complications of critical illness Objectives : To investigate whether a daily exercise session , using a bedside cycle ergometer , is a safe and effective intervention in preventing or attenuating the decrease in functional exercise capacity , functional status , and quadriceps force that is associated with prolonged intensive care unit stay . A prolonged stay in the intensive care unit is associated with muscle dysfunction , which may contribute to an impaired functional status up to 1 yr after hospital discharge . No evidence is available concerning the effectiveness of an early exercise training intervention to prevent these detrimental complications . Design : R and omized controlled trial . Setting : Medical and surgical intensive care unit at University Hospital Gasthuisberg . Patients : Ninety critically ill patients were included as soon as their cardiorespiratory condition allowed bedside cycling exercise ( starting from day 5 ) , given they still had an expected prolonged intensive care unit stay of at least 7 more days . Interventions : Both groups received respiratory physiotherapy and a daily st and ardized passive or active motion session of upper and lower limbs . In addition , the treatment group performed a passive or active exercise training session for 20 mins/day , using a bedside ergometer . Measurements and Main Results : All outcome data are reflective for survivors . Quadriceps force and functional status were assessed at intensive care unit discharge and hospital discharge . Six-minute walking distance was measured at hospital discharge . No adverse events were identified during and immediately after the exercise training . At intensive care unit discharge , quadriceps force and functional status were not different between groups . At hospital discharge , 6-min walking distance , isometric quadriceps force , and the subjective feeling of functional well-being ( as measured with “ Physical Functioning ” item of the Short Form 36 Health Survey question naire ) were significantly higher in the treatment group ( p < .05 ) . Conclusions : Early exercise training in critically ill intensive care unit survivors enhanced recovery of functional exercise capacity , self-perceived functional status , and muscle force at hospital discharge OBJECTIVE We compared a case-series of ten patients who developed prolonged neuromuscular weakness after continuous , nondepolarizing , neuromuscular blockade with a group of controls without neuromuscular weakness to determine the economic impact of the neuromuscular weakness . DESIGN Frequency-matched case control trial . SETTING Medical and surgical intensive care units of a 937-bed tertiary care , university-affiliated teaching hospital . PATIENTS Ten patients developed prolonged neuromuscular weakness after continuous administration of nondepolarizing neuromuscular blockers . Ten patients from a 1994 drug utilization data base who did not develop motor weakness after paralysis were identified to serve as controls . MEASUREMENTS AND MAIN RESULTS The medical and accounting records of the patients were retrospectively review ed . Charge data were obtained from patient accounts . Institutional ratios to convert charges to full costs and marginal costs were obtained from the Hospital Finance Department of Henry Ford Hospital . The economic impact of the diagnosis and recovery of the motor weakness was estimated for the intensive care unit ( ICU ) and hospital stays and compared with those values for control patients . Median hospital charges ( excluding rehabilitation ) , totaling $ 91,476 , were attributed to the patients who developed neuromuscular weakness and included charges for neuromuscular blocking agents , continuous mechanical ventilation , ICU and hospital beds , neurologic studies , and physical therapy services . In the control patients , median charges were $ 22,191 ( p = .001 ) . The total median cost differential for a patient in the neuromuscular weakness group was in excess of $ 66,713 ( 95 % confidence interval $ 23,485 to $ 189,214 , p = .001 ) . Significant differences were also found for patient charges , full costs , and marginal costs for mechanical ventilation ( p = .002 ) , neurologic studies ( p = .014 ) , as well as ICU ( p = .002 ) and hospital ( p = .001 ) stays . CONCLUSIONS The development of motor weakness was associated with an increase in ICU and hospital stays , continued mechanical ventilation , and disproportionate healthcare expenditures in excess of $ 66,000 per patient . A prospect i ve evaluation of the true prevalence of neuromuscular weakness after neuromuscular blockade and of the costs to the healthcare system is needed RATIONALE Intensive care unit (ICU)-acquired weakness is a frequent complication of critical illness . It is unclear whether it is a marker or mediator of poor outcomes . OBJECTIVES To determine acute outcomes , 1-year mortality , and costs of ICU-acquired weakness among long-stay ( ≥8 d ) ICU patients and to assess the impact of recovery of weakness at ICU discharge . METHODS Data were prospect ively collected during a r and omized controlled trial . Impact of weakness on outcomes and costs was analyzed with a one-to-one propensity-score-matching for baseline characteristics , illness severity , and risk factor exposure before assessment . Among weak patients , impact of persistent weakness at ICU discharge on risk of death after 1 year was examined with multivariable Cox proportional hazards analysis . MEASUREMENTS AND MAIN RESULTS A total of 78.6 % were admitted to the surgical ICU ; 227 of 415 ( 55 % ) long-stay assessable ICU patients were weak ; 122 weak patients were matched to 122 not-weak patients . As compared with matched not-weak patients , weak patients had a lower likelihood for live weaning from mechanical ventilation ( hazard ratio [ HR ] , 0.709 [ 0.549 - 0.888 ] ; P = 0.009 ) , live ICU ( HR , 0.698 [ 0.553 - 0.861 ] ; P = 0.008 ) and hospital discharge ( HR , 0.680 [ 0.514 - 0.871 ] ; P = 0.007 ) . In-hospital costs per patient ( + 30.5 % , + 5,443 Euro per patient ; P = 0.04 ) and 1-year mortality ( 30.6 % vs. 17.2 % ; P = 0.015 ) were also higher . The 105 of 227 ( 46 % ) weak patients not matchable to not-weak patients had even worse prognosis and higher costs . The 1-year risk of death was further increased if weakness persisted and was more severe as compared with recovery of weakness at ICU discharge ( P < 0.001 ) . CONCLUSIONS After careful matching the data suggest that ICU-acquired weakness worsens acute morbidity and increases healthcare-related costs and 1-year mortality . Persistence and severity of weakness at ICU discharge further increased 1-year mortality . Clinical trial registered with www . clinical trials.gov ( NCT 00512122 ) Introduction The purpose of this trial was to investigate the effectiveness of an exercise rehabilitation program commencing during ICU admission and continuing into the outpatient setting compared with usual care on physical function and health-related quality of life in ICU survivors . Methods We conducted a single-center , assessor-blinded , r and omized controlled trial . One hundred and fifty participants were stratified and r and omized to receive usual care or intervention if they were in the ICU for 5 days or more and had no permanent neurological insult . The intervention group received intensive exercises in the ICU and the ward and as out patients . Participants were assessed at recruitment , ICU admission , hospital discharge and at 3- , 6- and 12-month follow-up . Physical function was evaluated using the Six-Minute Walk Test ( 6MWT ) ( primary outcome ) , the Timed Up and Go Test and the Physical Function in ICU Test . Patient-reported outcomes were measured using the Short Form 36 Health Survey , version 2 ( SF-36v2 ) and Assessment of Quality of Life ( AQoL ) Instrument . Data were analyzed using mixed models . Results The a priori enrollment goal was not reached . There were no between-group differences in demographic and hospital data , including acuity and length of acute hospital stay ( LOS ) ( Acute Physiology and Chronic Health Evaluation II score : 21 vs 19 ; hospital LOS : 20 vs 24 days ) . No significant differences were found for the primary outcome of 6MWT or any other outcomes at 12 months after ICU discharge . However , exploratory analyses showed the rate of change over time and mean between-group differences in 6MWT from first assessment were greater in the intervention group . Conclusions Further research examining the trajectory of improvement with rehabilitation is warranted in this population .Trial registration The trial was registered with the Australian New Zeal and Clinical Trials Registry ACTRN12605000776606 Introduction Critical illness polyneuromyopathy ( CIPNM ) is a common complication of critical illness presenting with muscle weakness and is associated with increased duration of mechanical ventilation and weaning period . No preventive tool and no specific treatment have been proposed so far for CIPNM . Electrical muscle stimulation ( EMS ) has been shown to be beneficial in patients with severe chronic heart failure and chronic obstructive pulmonary disease . Aim of our study was to assess the efficacy of EMS in preventing CIPNM in critically ill patients . Methods One hundred and forty consecutive critically ill patients with an APACHE II score ≥ 13 were r and omly assigned after stratification to the EMS group ( n = 68 ) ( age:61 ± 19 years ) ( APACHE II:18 ± 4 , SOFA:9 ± 3 ) or to the 
    Output:
    
, IMPLICATION S OF KEY FINDINGS Early rehabilitation was associated with a decreased likelihood of developing ICUAW .
Our findings support early rehabilitation in the ICU .