Effectiveness of rehabilitation interventions in adults with multi-organ dysfunction syndrome: A rapid review
Chiara Arienti, Stefano G. Lazzarini, Elisa Pollini, Michele Patrini, Carlotte Kiekens, Stefano Negrini
IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
Background: Multiple organ dysfunction syndrome, defined as altered organ function in critically ill patients, is a possible consequence of COVID-19. Investigating the current evidence is therefore crucial in this pandemic, as early rehabilitation could be effective for the functioning of patients with multiple organ failure. This rapid review assesses the effectiveness of rehabilitation interventions in adults with multiple organ dysfunction syndrome.
Methods: A rapid review was conducted including only randomised control trials, published until 30 November 2020. All databases were investigated and the results synthesized narratively, evaluating the risk of bias and quality of evidence in all included studies.
Results: A total of 404 records were identified through database searches. After removal of duplicates 346 articles remained. After screening, 3 studies (90 participants) met the inclusion criteria. All studies reported positive effects of neuromuscular electrical stimulation on muscle mass preservation compared with no treatment or standard physio-therapy.
Conclusion: The lack of evidence on the effectiveness of rehabilitation interventions does not allow any firm conclusion to be drawn. Neuromuscular electrical stimulation might be a possible rehabilitation intervention to prevent muscle volume loss and improve function in patients with multiple organ dysfunction syndrome. However, further studies are needed to support these preliminary findings.
This paper synthesizes the current evidence on the effects of rehabilitation interventions in patients with multi-organ dysfunction syndrome. The results show that neuromuscular electrical stimulation may be a feasible treatment to prevent muscle mass loss and increase upper and lower limb strength in this population. Following multi-organ dysfunction syndrome people frequently experience new or worsened disabilities. Therefore, it is relevant to provide the clinician with the best current evidence on treatment that could be applied in the acute phase, in order to enhance the recovery of these patients. This is even more applicable while the COVID-19 pandemic is raging globally, as multi-organ dysfunction syndrome is one of the worst possible consequences of the disease.
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