Patient Responses to Early Therapeutic Mobility (Activity) in the Intensive Care Unit (ICU)

2.50
Hdl Handle:
http://hdl.handle.net/10755/158438
Type:
Presentation
Title:
Patient Responses to Early Therapeutic Mobility (Activity) in the Intensive Care Unit (ICU)
Abstract:
Patient Responses to Early Therapeutic Mobility (Activity) in the Intensive Care Unit (ICU)
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2009
Author:Winkelman, Chris, PhD
P.I. Institution Name:Case Western Reserve University
Title:Frances Payne Bolton School of Nursing
Contact Address:10900 Euclid Ave, Cleveland, OH, 44106, USA
Contact Telephone:216.368-0700
Co-Authors:C. Winkelman, E. Liou, K. Peereboom, J. Tenhover, Case Western Reserve University, Cleveland, OH; R. Hejal, J. Rowbottom, University Hospitals Case Medical Center, Cleveland , OH; J. Daly, Louis Stokes Veterans Medical Center, Cleveland, OH;
Purpose: Compare responses to in-bed to out-of bed activity among ICU patients. Specific aims: a.Compare physiological responses: peripheral oxygen saturation, heart rate, blood pressure, new dysrhythmias, muscle strength. b. Compare adverse events including pain, fatigue, line or tube dislodgement, fall or near fall. Framework: Creditor's framework details specific immbility hazards for hospitalized older adults. There are limited data about how critically ill patients respond to therapeutic, progressive activity. Methods: Repeated measures, interventional. Analyses: 37 subjects from the ICUs in an academic hospital have been enrolled to date. The typical subject was aged 66 years, female (54%) with an APACHE score of 65 and mechanically ventilated for 11 days. In-bed activity (e.g., range of motion) versus out-of-bed activity results in a statistically significant (ANOVA) but clinically unimportant heart rate increase of 6 beats/minute whereas differences systolic blood pressure and peripheral oxygenation (baseline to highest or lowest value) were not significant. One week after enrollment, there were 22 patients who remained in bed. Bedfast patients had similar muscle strength compared to mechanically ventilated patients who got out of bed. No subjects experienced dysrhythmias or unsafe events requiring intervention. There were no differences in age, severity of illness or diagnoses in patients with inbed versus out-of-bed activity. Interpretations: These patients demonstrated significant physiologic stability performing inbed or out of bed activity. Relevance: Critically ill patient responses to therapeutic mobility activities are not well characterized. This preliminary study suggests that differences vital sign changes are not significant when comparing out of bed activity in this sample. Findings suggest the progressive mobility does not cause orthostatic changes or adverse events in this sample. Funding: Hill-Rom and CTSC Dahms Clinical Research Unit Grant Number UL1 RR024989 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH) and its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePatient Responses to Early Therapeutic Mobility (Activity) in the Intensive Care Unit (ICU)en_GB
dc.identifier.urihttp://hdl.handle.net/10755/158438-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Patient Responses to Early Therapeutic Mobility (Activity) in the Intensive Care Unit (ICU)</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Winkelman, Chris, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Case Western Reserve University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Frances Payne Bolton School of Nursing</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">10900 Euclid Ave, Cleveland, OH, 44106, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">216.368-0700</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">chris.winkelman@case.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">C. Winkelman, E. Liou, K. Peereboom, J. Tenhover, Case Western Reserve University, Cleveland, OH; R. Hejal, J. Rowbottom, University Hospitals Case Medical Center, Cleveland , OH; J. Daly, Louis Stokes Veterans Medical Center, Cleveland, OH;</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Compare responses to in-bed to out-of bed activity among ICU patients. Specific aims: a.Compare physiological responses: peripheral oxygen saturation, heart rate, blood pressure, new dysrhythmias, muscle strength. b. Compare adverse events including pain, fatigue, line or tube dislodgement, fall or near fall. Framework: Creditor's framework details specific immbility hazards for hospitalized older adults. There are limited data about how critically ill patients respond to therapeutic, progressive activity. Methods: Repeated measures, interventional. Analyses: 37 subjects from the ICUs in an academic hospital have been enrolled to date. The typical subject was aged 66 years, female (54%) with an APACHE score of 65 and mechanically ventilated for 11 days. In-bed activity (e.g., range of motion) versus out-of-bed activity results in a statistically significant (ANOVA) but clinically unimportant heart rate increase of 6 beats/minute whereas differences systolic blood pressure and peripheral oxygenation (baseline to highest or lowest value) were not significant. One week after enrollment, there were 22 patients who remained in bed. Bedfast patients had similar muscle strength compared to mechanically ventilated patients who got out of bed. No subjects experienced dysrhythmias or unsafe events requiring intervention. There were no differences in age, severity of illness or diagnoses in patients with inbed versus out-of-bed activity. Interpretations: These patients demonstrated significant physiologic stability performing inbed or out of bed activity. Relevance: Critically ill patient responses to therapeutic mobility activities are not well characterized. This preliminary study suggests that differences vital sign changes are not significant when comparing out of bed activity in this sample. Findings suggest the progressive mobility does not cause orthostatic changes or adverse events in this sample. Funding: Hill-Rom and CTSC Dahms Clinical Research Unit Grant Number UL1 RR024989 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH) and its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH.</td></tr></table>en_GB
dc.date.available2011-10-26T21:03:13Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T21:03:13Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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