Table 3.
Baseline evaluation, direct and remote assessment in critically ill patients, overall and depending on their response to corporeal rehabilitation care
| Parameter | N | All patients (n = 287) | Non-responders (n = 99) | Responders (n = 188) | p value |
|---|---|---|---|---|---|
| Baseline evaluation | |||||
| Pre-inclusion time (days)* | 287 | 3 [2–7] | 3 [2–7] | 3 [2–7] | 0.613 |
| Days of IMV before inclusion | 72 | 8 [5–22] | 7 [4–23] | 9 [5–20] | 0.582 |
| Hemodynamics | |||||
| Heart rate (bpm) | 287 | 90 [79–104] | 90 [78–102] | 90 [80–104] | 0.612 |
| SAP (mmHg) | 287 | 127 [115–141] | 127 [115–141] | 128 [114–141] | 0.750 |
| DAP (mmHg) | 287 | 70 [62–80] | 68 [60–79] | 71 [63–82] | 0.048 |
| MAP (mmHg) | 287 | 92 [82–101] | 92 [82–98] | 92 [82–102] | 0.504 |
| Comfort | |||||
| Pain score | 263 | 4 [0–6] | 3 [0–6] | 4 [0–7] | 0.108 |
| Stress score | 263 | 4 [0–7] | 0 [0–5] | 5 [0–7] | < 0.001 |
| Dyspnea score | 112 | 2 [1–3] | 2 [0–3] | 2 [1–3] | 0.690 |
| Well-being score | 259 | 5 [4–7] | 6 [5–8] | 5 [3–6] | < 0.001 |
| Discomfort | 287 | 45 (16%) | 15 (15%) | 30 (16%) | 0.858 |
| Neurological function | |||||
| Continuous sedation or analgesia | 287 | 10 (4%) | 1 (1%) | 9 (5%) | 0.173 |
| Midazolam | 287 | 1 (0%) | 0 (0%) | 1 (1%) | > 0.99 |
| Sufentanyl | 287 | 9 (3%) | 1 (1%) | 8 (4%) | 0.171 |
| Neuroleptic | 287 | 2 (1%) | 0 (0%) | 2 (1%) | 0.547 |
| Morphine | 287 | 64 (22%) | 18 (18%) | 46 (25%) | 0.224 |
| Physical disability | 287 | 20 (7%) | 5 (5%) | 15 (8%) | 0.354 |
| Ventilation | |||||
| IMV | 286 | 25 (9%) | 9 (9%) | 16 (9%) | 0.848 |
| Assist-control mode | 287 | 2 (1%) | 2 (2%) | 0 (0%) | 0.118 |
| Tidal volume (mL) | 30 | 517 [420–591] | 455 [394–254] | 541 [478–642] | 0.081 |
| Tidal volume (mL/kg IPW) | 28 | 8 [7–10] | 8 [6–9] | 9 [7–10] | 0.248 |
| End-tidal CO2 mmHg | 25 | 33 [29–38] | 33 [28–38] | 31 [28–37] | 0.755 |
| FiO2 (%) | 39 | 35 [30–45] | 35 [30–48] | 35 [30–40] | 0.739 |
| Oxygen flow (L/min) | 217 | 0 [0–2] | 0 [0–2] | 0 [0–2] | 0.937 |
| SpO2 (%) | 287 | 97 [95–99] | 97 [95–99] | 97 [95–99] | 0.586 |
| Respiratory rate (bpm) | 287 | 22 [18–27] | 22 [18–28] | 22 [18–27] | 0.635 |
| Intercostal retraction | 287 | 5 (2%) | 2 (2%) | 3 (2%) | > 0.99 |
| Paradoxical breathing | 287 | 8 (3%) | 2 (2%) | 6 (3%) | 0.719 |
| Last available blood gases | |||||
| pH | 235 | 7.43 [7.39–7.47] | 7.43 [7.40–7.47] | 7.43 [7.38–7.46] | 0.213 |
| PaO2/FiO2 ratio (mmHg) | 234 | 333 [238–417] | 333 [217–416] | 339 [250–418] | 0.664 |
| PaCO2 (mmHg) | 234 | 38 [32–44] | 36 [33–44] | 38 [32–44] | 0.741 |
| Bicarbonates (mmol/L) | 234 | 26 [23–29] | 26 [23–29] | 26 [23–29] | 0.771 |
| Lactates (mmol/L) | 234 | 1 [1–2] | 1 [1–2] | 1 [1–2] | 0.941 |
| SaO2 (%) | 235 | 96 [94–98] | 96 [94–98] | 96 [94–98] | 0.745 |
| Corporeal rehabilitation care (CRC) | |||||
| Pre-evaluation time# (min) | 186 | 15 [5–30] | 10 [4–27] | 18 [7–31] | 0.122 |
| Face and forehead massage | 287 | 204 (71%) | 70 (71%) | 134 (71%) | 0.919 |
| Manicure | 287 | 61 (21%) | 19 (19%) | 42 (22%) | 0.535 |
| Pedicure | 287 | 50 (17%) | 19 (19%) | 31 (17%) | 0.566 |
| Scalp massage | 287 | 37 (13%) | 13 (13%) | 24 (13%) | 0.930 |
| Other interventions | 287 | 51 (18%) | 17 (17%) | 34 (18%) | 0.847 |
| Duration of CRC (min) | 287 | 25 [20–30] | 25 [20–30] | 25 [25–30] | 0.016 |
| Direct evaluation | |||||
| Time from CRC$ (min) | 174 | 8 [3–15] | 10 [2–17] | 7 [4–15] | 0.646 |
| Hemodynamics | |||||
| Heart rate (bpm) | 286 | 89 [78–101] | 84 [72–102] | 91 [80–100] | 0.105 |
| SAP (mmHg) | 286 | 128 [112–140] | 129 [111–144] | 127 [113–139] | 0.661 |
| DAP (mmHg) | 286 | 71 [62–79] | 69 [61–78] | 72 [62–81] | 0.186 |
| MAP (mmHg) | 286 | 91 [80–102] | 93 [80–101] | 91 [80–102] | 0.742 |
| Comfort | |||||
| Pain score | 258 | 2 [0–5] | 3 [0–6] | 2 [0–5] | 0.223 |
| Stress score | 258 | 2 [0–5] | 1 [0–5] | 2 [0–5] | 0.555 |
| Dyspnea score | 112 | 2 [1–2] | 2 [1–2] | 2 [1–2] | 0.347 |
| Well-being score | 257 | 8 [6–10] | 7 [5–8] | 8 [6–10] | < 0.001 |
| Discomfort | 286 | 7 (2%) | 3 (3%) | 4 (2%) | 0.694 |
| Change in comfort£ | |||||
| Δ1 Pain score | 256 | 0 [− 2 to 0] | 0 [0–0] | − 1 [− 3 to 0] | < 0.001 |
| Δ1 Stress score | 256 | 0 [− 2 to 0] | 0 [0–0] | − 1 [− 3 to 0] | < 0.001 |
| Δ1 Dyspnea score | 112 | 0 [− 2 to 0] | 0 [− 1 to 0] | 0 [− 2 to 0] | 0.870 |
| Δ1 Well-being score | 254 | 2 [0–4] | 0 [0–1] | 3 [1–5] | < 0.001 |
| Ventilation | |||||
| Respiratory rate (bpm) | 286 | 21 [18–25] | 21 [17–26] | 21 [18–25] | 0.820 |
| Intercostal retraction | 286 | 4 (1%) | 2 (2%) | 2 (1%) | 0.609 |
| Paradoxical breathing | 286 | 2 (1%) | 1 (1%) | 1 (1%) | > 0.99 |
| Patient appreciation of the CRC session | |||||
| Usefulness | 256 | 10 [8–10] | 8 [7–10] | 10 [8–10] | < 0.001 |
| Satisfaction | 256 | 10 [8–10] | 9 [8–10] | 10 [8–10] | 0.002 |
| Patient’s wish to renew care | 260 | 249 (96%) | 68 (94%) | 181 (96%) | 0.503 |
| Remote assessment | |||||
| Time from CRC$$ (min) | 131 | 71 [57–93] | 63 [50–94] | 72 [60–94] | 0.165 |
| Hemodynamics | |||||
| Heart rate (bpm) | 224 | 89 [79–100] | 86 [76–100] | 90 [80–100] | 0.379 |
| SAP (mmHg) | 224 | 125 [112–138] | 123 [109–134] | 126 [113–139] | 0.114 |
| DAP (mmHg) | 224 | 71 [60–80] | 67 [57–78] | 72 [61–82] | 0.005 |
| MAP (mmHg) | 224 | 90 [79–100] | 86 [77–97] | 91 [81–102] | 0.035 |
| Discomfort | 223 | 10 (5%) | 2 (3%) | 8 (5%) | 0.728 |
| Comfort | |||||
| Δ2 Pain sore | 204 | 2 [0–5] | 0 [0–5] | 2 [0–5] | 0.752 |
| Δ2 Stress score | 203 | 0 (0–5] | 0 (0–5] | 0 (0–5] | 0.705 |
| Δ2 Dyspnea score | 111 | 2 [1–2] | 2 [1–3] | 2 [1–2] | 0.723 |
| Δ2 Well-being score | 203 | 8 [6–10] | 7 [5–9] | 8 [6–10] | 0.043 |
| Change in comfort£ | |||||
| Δ2 Pain score | 202 | 0 [− 2 to 0] | 0 [0–0] | 0 [− 2 to 0] | 0.012 |
| Δ2 Stress score | 202 | 0 [− 2 to 0] | 0 [0–0] | − 1 [− 3 to 0] | < 0.001 |
| Δ2 Dyspnea score | 111 | 0 [− 1 to 0] | 0 [0–0] | 0 [− 1 to 0] | 0.673 |
| Δ2 Well-being score | 202 | 1 [0–4] | 0 [0–1] | 2 [0–4] | < 0.001 |
| Ventilation | |||||
| Respiratory rate (bpm) | 224 | 21 [17–26] | 20 [17–25] | 22 [18–26] | 0.431 |
| Intercostal retraction | 223 | 2 (1%) | 1 (1%) | 1 (1%) | 0.530 |
| Paradoxical breathing | 223 | 2 (1%) | 2 (3%) | 0 (0%) | 0.98 |
| Outcome | |||||
| ICU stay (days) | 287 | 6 [4–12] | 6 [4–12] | 7 [4–14] | 0.528 |
| Death at day 28 | 287 | 22 (8%) | 15 (15%) | 7 (4%) | 0.001 |
Δ1: absolute difference between the value at direct evaluation and the value at baseline; Δ2: absolute difference between the value at remote evaluation and the value at baseline
IMV invasive mechanical ventilation, IPW ideal predicted weight, CO2 carbon dioxide, FiO2 inspired oxygen fraction, SpO2 oxygen transcutaneous saturation
*Days between ICU admission and inclusion
#Time between baseline assessment and CRC start in minutes
$Time between CRC end and direct intervention assessment in minutes
$$Time between CRC end and remote evaluation in minutes
£Change in score as compared with baseline