Understanding critically ill patients hemodynamic response to mobilization: Using the evidence to make it safe and feasible

Critical Care Nursing Quarterly

Volumn 36, Issue 1, 2013, Pages 17-27

  Vollman, Kathleen M ^a  

^a Advancing Nursing LLC   (United States)

Author keywords

critical care; culture; early mobility; hemodynamic instability; immobility; mobilization

Indexed keywords

ACUTE LUNG INJURY; ARTICLE; ATELECTASIS; AUTONOMIC DYSFUNCTION; BED REST; BLOOD VOLUME; BODY MASS; BREATHING RATE; CARDIOVASCULAR RESPONSE; CONTINUOUS RENAL REPLACEMENT THERAPY; CORONARY ARTERY BYPASS GRAFT; CRITICALLY ILL PATIENT; DEVICE REMOVAL; DRUG SAFETY; FEASIBILITY STUDY; HEART EJECTION FRACTION; HEART STROKE VOLUME; HEMODYNAMICS; HUMAN; HYPOVOLEMIA; INSULIN RESISTANCE; INTENSIVE CARE UNIT; MEAN ARTERIAL PRESSURE; MOBILIZATION; OXYGEN CONSUMPTION; OXYGEN DESATURATION; OXYGEN SATURATION; OXYGEN SUPPLY; OXYGENATION; PATIENT SAFETY; POSITIVE END EXPIRATORY PRESSURE; PRESSORECEPTOR; PRESSORECEPTOR REFLEX; RANDOMIZED CONTROLLED TRIAL (TOPIC); RESUSCITATION; STRETCH RECEPTOR; SYSTOLIC BLOOD PRESSURE; VENTILATOR ASSOCIATED PNEUMONIA;

BED REST; CRITICAL ILLNESS; EARLY AMBULATION; HEMODYNAMICS; HUMANS; MOBILITY LIMITATION; ORTHOSTATIC INTOLERANCE; PATIENT SAFETY;

EID: 84871762377     PISSN: 08879303     EISSN: 15505111     Source Type: Journal    
DOI: 10.1097/CNQ.0b013e3182750767     Document Type: Article

References (63)

1. Schweickert WD, Pohlman MC, Pohlman AS, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomized controlled trial. Lancet. 2009; 373:1874-1882.
2. De Jonnghe B, Bastuji-Garin S, Durand MC, et al. Respiratory weakness is associated with limb weakness and delayed weaning in critical illness. Crit Care Med. 2007;39:2007-2015.
3. Kortebein P, Ferrando A, Lombeida J, Wolfe R, Evans WJ. Effect of 10 days of bed rest on skeletal muscle in healthy older adults. JAMA. 2007;297: 1772-1774.
4. Greenleaf JE, Kozlowski S. Physiological consequences of reduced activity during bed rest. Exerc Sport Sci Rev. 1982;10:84-119.
5. Morris PE, Goad A, Thompson C, et al. Early intensive care mobility therapy in the treatment of acute respiratory failure. Crit Care Med. 2008;36:2238-2243.
6. Topp R, Ditmyer M, King K, Doherty K, Hornyak J III. The effect of bed rest and potential prehabilitation on patients in the intensive care unit. AACN Clin Issues. 2002;13(2):263-276.
7. Reddy M, Gill SS, Rochon PA. Preventing pressure ulcers: a systematic review. JAMA. 2006;296(8):974-983.
8. Vollman KM. Ventilator-associated pneumonia and pressure ulcer prevention as targets for quality improvement in the ICU. Crit Care Nurs Clin N Am. 2006;18:453-467.
9. Morris PE, Griffin L, Berry M, et al. Receiving early mobility during an intensive care unit admission is a predictor of improved outcomes in acute respiratory failure. Am J Med Sci. 2011;341(5):373-377.
10. Herridge MS, Tansey CM, Matte A, et al. Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med. 2011;364(14):1293-1304.
11. Herridge MS, Cheung AM, Tansey CM, et al. One year outcomes in survivors of the acute respiratory distress syndrome. N Engl J Med. 2003;348(8):683-693.
12. Hopkins RO, Weaver LK, Collingridge D, Parkinson RB, Chan KJ, Orme JF Jr. Two-year cognitive, emotional, and quality-of-life outcomes in acute respiratory distress syndrome. Am J Respir Crit Care Med. 2005;171(4):340-347.
13. Dowdy DW, Eid MP, Sedrakyan A, et al. Quality of life in adult survivors of critical illness: a systematic review of the literature. Intensive Care Med. 2005;31(5):611-620.
14. Dowdy DW, Eid MP, Dennison CR, et al. Quality of life after acute respiratory distress syndrome: a metaanalysis. Intensive Care Med. 2006;32(8):1115-1124.
15. Needham DM. Mobilizing patients in the intensive care unit: improving neuromuscular weakness and physical function. JAMA. 2008;300(14):1685-1690.
16. Vollman KM. Introduction to progressive mobility. Crit Care Nurse. 2010;30(2):S3-S5.
17. Stiller K. Safety issues that should be considered when mobilizing critically ill patients Crit Care Clin. 2007;23:35-53.
18. Hopkins RO, Spuhler VJ, Thomsen GE. Transforming ICU culture to facilitate early mobility. Crit Care Clin. 2007;23(1):81-96.
19. Winkelman C, Peereboom K. Staff-perceived barriers and facilitators. Crit Care Nurse. 2010;30:13-16.
20. Fortney SM, Schneider VS, Greenleaf JE. The Physiology of Bedrest. Vol 2. New York, NY: Oxford University Press; 1996.
21. Hamburg NM, McMackin CJ, Huang AL, et al. Physical inactivity rapidly induces insulin resistance and microvascular dysfunction in healthy volunteers. Arterioscler Thromb Vasc Biol. 2007;27(12):2650-2656.
22. Convertino VA. Cardiovascular consequences of bed rest: effect on maximal oxygen uptake. Med Sci Sports Exerc. 1997;29:191-196.
23. Convertino V, Hung J, Goldwater D, DeBusk RF: Cardiovascular responses to exercise inmiddle-aged men after 10 days of bed rest. Circulation. 1982;65:134-140.
24. Perhonen MA, Franco F, Lane LD, et al. Cardiac atrophy after bed rest and spaceflight. J Appl Physiol. 2001;91(2):645-653.
25. Levine BD, Zuckerman JH, Pawelczyk JA. Cardiac atrophy after bed-rest deconditioning: a nonneural mechanism for orthostatic intolerance. Circulation. 1997;96(2):517-525.
26. Convertino VA, Doerr DF, Eckberg DL, Fritsch JM, Vernikos-Danellis J. Head-down bed rest impairs vagal baroreflex responses and provokes orthostatic hypotension. J Appl Physiol. 1990;68:1458-1464.
27. Convertino VA. G-factor as a tool in basic research: mechanisms of orthostatic tolerance. J Gravit Physiol. 1999;6(1):P73-P76.
28. Convertino VA. Mechanisms of microgravity induced orthostatic intolerance: implications for effective countermeasures. J Gravit Physiol. 2002;9(2):1-13.
29. Convertino VA. Clinical aspects of the control of plasma volume at microgravity and during return to one gravity. Med Sci Sports Exerc. 1996;28(10, suppl):S45-S52.
30. Convertino VA. Consequences of cardiovascular adaptation to spaceflight: implications for the use of pharmacological countermeasures. Gravit Space Biol Bull. 2005;18(2):59-69.
31. Iwasaki K, Zhang R, Perhonen MA, Zuckerman JH, Levine BD. Reduced baroreflex control of heart period after bed rest is normalized by acute plasma volume restoration. Am J Physiol Regul Integr Comp Physiol. 2004;287:R1256- R1262.
32. Schmedtje JF Jr, Liu WL, Taylor AA. Cardiovascular deconditioning through head-down tilt bed rest increases blood pressure variability and plasma renin activity. Aviat Space Environ Med. 1996;67(6):539-546.
33. Pavy-LeTraon A, Heer M, Narici MV, Rittweger J, Vernikos J. From space to earth: advances in human physiology for 20 years of bedrest studies (1986-2006). Eur J Appl Physiol. 2007;101(2):143-194.
34. Convertino VA, Previc FH, Ludwig DA, Engelken EJ. Effects of vestibular and oculomotor stimulation on responsiveness of the carotid-cardiac baroreflex. Am J Physiol. 1997;273(47):615-622.
35. Wilson TD, Cotter LA, Draper JA, et al. Effects of postural changes and removal of vestibular inputs on blood flow to the head of conscious felines. J Appl Physiol. 2006;100(5):1475-1482.
36. Cooke WH. Head rotation during upright tilt increases cardiovagal baroreflex sensitivity. Aviat Space Environ Med. 2007;78(5):463-469.
37. Doering LV. The effect of positioning on hemodynamics and gas exchange in the critically ill: a review. Am J Crit Care. 1993;2(3): 208-216.
38. Winslow EH, Clark AP, White KM, Tyler DO. Effects of a lateral turn on mixed venous oxygen saturation and heart rate in critically ill adults. Heart Lung. 1990;19:555-561.
39. Noll ML, Fountain RL, Duncan CA, Weaver L, Osmanski VP, Halfmans S. Fluctuations in mixed venous oxygen saturation in critically ill medical patients: a pilot study. Am J Crit Care. 1992;1:102-106.
40. Gawlinski A. Effect of positioning on mixed venous oxygen saturation. J Cardiovasc Nurs. 1993;7(4):71-81.
41. Miwa C, Sugiyama Y, Mano T, et al. Effects of aging on cardiovascular responses to gravity-related fluid shift in humans. J Gerontol A Biol Sci Med Sci. 2000;55(6):M329-M335.
42. Kenny RA. Advances in the treatment of orthostatic hypotension. Clin Geriatr. 2000;8(7, suppl):S1-S4.
43. Zhang Y, Critchley LA, Tam YH, Tomlinson B. Shortterm postural reflexes in diabetic patients with autonomic dysfunction. Diabetologia. 2004;47:304-311.
44. Shively M. Effect of position change on mixed venous oxygen saturation in coronary artery bypass surgery patients. Heart Lung. 1988;17:51-59.
45. Gawlinski A, Dracup K. Effect of positioning on SvO2 in critically ill patient with a low ejection fraction. Nurs Res. 1998;47(5):293-303.
46. Lewis P, Nichols E, Mackey G, et al. The effect of turning and backrub on mix venous oxygen saturation in critically ill patients. Am J Crit Care. 1997;6:132-140.
47. Kirkeby-Garstad I, Wisloff U, Skogvoll E, et al. The marked reduction in mixed venous oxygen saturation during early mobilization after cardiac surgery: the effect of posture or exercise? Anesth Analg. 2006;102(6):1609-1616.
48. Kirkeby-Garstad I, Sellevold OF, Stenseth R, Skogvoll E, Karevold A. Marked mixed venous desaturation during early mobilization after aortic valve surgery. Anesth Analg. 2004;98(2):311-317.
49. Winslow EH, Lane LD, Woods RJ. Dangling: a review of relevant physiology, research, and practice. Heart Lung. 1995;24(4):263-272.
50. Price P. Physiologic effects of first-time sitting among male patients after coronary artery bypass graft surgery. Dynamics. 2006;17(1):12-19.
51. Dingle M. Role of dangling when moving from supine to standing position. Br J Nurs. 2003;12(6):346-350.
52. Hamlin SK, Hanneman SK, Wachtel S, Gusick G. Adverse hemodynamic effects of lateral rotation during mechanical ventilation. Dimens Crit Care Nurs. 2008;27(2):54-61.
53. Van Den Burg PC, Jansen JR, Pinsky MR. Effect of positive pressure on venous return in volume loaded cardiac surgical patients. J Appl Physiol. 2002;92:1223-1231.
54. Nakao S, Come PC, Makay RG, Ransil BJ. Effects of positional changes on inferior vena caval size and dynamics and correlations with right-sided cardiac pressure. Am J Cardiol. 1987;59:125-132.
55. Banasik JL, Emerson RJ. Effect of lateral positions on tissue oxygenation in the critically ill. Heart Lung. 2001;30(4):269-276.
56. Vollman KM. Hemodynamic instability: is it really a barrier to turning critically ill patients? Crit Care Nurse. 2012;32(1):70-75.
57. Dean E. Mobilizing patients in the ICU: evidence and principles of practice. Acute Care Perspect. 2008;17(1):1.
58. Bassett RD, Vollman KM, Brandwene L, Murray T. Integrating a multidisciplinary mobility programme into intensive care practice (IMMPTP): a multicentre collaborative. Intensive Crit Care Nurs. 2012;28(2): 88-97.
59. Stiller K, Phillips AC, Lambert P: The safety of mobilisation and its effect on haemodynamic and respiratory status of intensive care patients. Physiother Theory Pract. 2004;20:175-185.
60. Bailey P, Thomsen GE, Spuhler VJ, et al. Early activity is feasible and safe in respiratory failure patients. Crit Care Med. 2007;35:139-145.
61. Pohlman MC, Schweickert WD, Pohlman AS, et al. Feasibility of physical and occupational therapy beginning from initiation of mechanical ventilation. Crit Care Med. 2010;38(11):2089-2094.
62. Korupolu R, Chandolu S, Needham D. Series on early mobilisation of critically ill patients part one: screening and safety issues. ICU Manag. 2009;9(3): 27-29.
63. Vollman KM. Back to the fundamentals of care: why now, why us. Aust Crit Care. 2009;22: 152-154.