Sécurité de la rééducation précoce en neuro-réanimation : jusqu'où peut-on aller ? Revue systématique de la littérature et méta-analyse des évènements indésirables
Bibliographic record
Abstract
Current evidence supports early mobilization (EM); rehabilitation of ICU patients,under mechanical ventilation or not, improves functional outcomes and is found to be safe.However, little is known about EM of neurocritical patients, especially because EM is still seen asa potentially dangerous intervention in neurological ICU patients.Objective: to review safety data regarding patient rehabilitation in the Neuro-ICU, and tocompute incidence of adverse events such as hemodynamic changes, clinical deterioration,removal or dysfunction of respiratory tubes, intravascular catheters, other external disposals andfalls.Material and Method: data Sources: systematic literature review, including searches of 4 databases. Eligible studies forthe statistical analysis evaluated adult patients who received an EM program in a Neuro-ICU atan early stage <7 days, and provided data to allow the computation of incidence of adverseevents.Data Extraction: number of patients, mobilization/rehabilitation sessions, type of interventionand session time, and potential safety events and adverse events with negative consequences(requiring intervention or additional therapy).Results: synthesis: heterogeneity was assessed by I-square statistics, and bias assessed by the Newcastle-Ottawa Scale and Cochrane risk of bias assessment. The literature search identified 1134 titles.There were 4 eligible publications for the statistical analysis part, evaluating 195 patients, with95 potential safety events (12%) and 3 safety events with consequence (0.4%), occurring in 793mobilization/rehabilitation sessions, with an average of 27.8 minutes/session. There washeterogeneity in the definition of these events. Most potential safety events were modificationsof vital signs without any clinical or therapeutic consequence.15 studies were used for systematic review.Conclusion: early rehabilitation in NICU appears to be safe with a low incidence of safety events, not havingany consequences for patient management.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.033 | 0.074 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.016 | 0.033 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.006 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".