Hyun Lee1, Young Jun Ko2, Gee Young Suh3, Jeong Hoon Yang4, Chi-Min Park5, Kyeongman Jeon3, Yun Hee Park6, Chi Ryang Chung7. 1. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 2. Department of Rehabilitation and Physical Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 3. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 4. Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 5. Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 6. Department of Physical Medicine and Rehabilitation, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea. 7. Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: ccrzzang@gmail.com.
Abstract
PURPOSE: To evaluate risk factors for potential safety events during mobility physical therapy sessions in the medical intensive care unit. METHODS: The safety profiles and potential risk factors of 99 patients who were admitted to the medical intensive care unit of a single teaching hospital in Korea between May 1 and December 31, 2013, were retrospectively evaluated. RESULTS: A total of 26 potential safety events (5.0%; 95% confidence interval [CI], 3.4%-7.3%) during 520 mobilization sessions were observed in 17 (17.2%; 95% CI, 10.6%-26.4%) of 99 patients. The common potential safety events were as follows in order of frequency: 11 events of tachypnea or bradypnea (2.1%; 95% CI, 1.1%-3.9%), 6 events of desaturation (1.2 %; 95% CI, 0.5%-2.6%), 4 events of tachypnea or bradycardia (0.8%; 95% CI, 0.3%-2.1%), 4 events of patients' intolerance (0.8%; 95% CI, 0.3%-2.1%), and 1 event of tracheostomy tube removal (0.2%; 95% CI, 0%-1.2%). In multivariate analysis, the use of extracorporeal membrane oxygenation was associated with potential adverse events with an adjusted odds ratio of 5.8 (95% CI, 2.2-15.6), respectively. CONCLUSION: Early mobility physical therapy performed by a newly established group was feasible for critically ill patients in Korea. However, potential safety events need to be monitored carefully for patients with extracorporeal membrane oxygenation support.
PURPOSE: To evaluate risk factors for potential safety events during mobility physical therapy sessions in the medical intensive care unit. METHODS: The safety profiles and potential risk factors of 99 patients who were admitted to the medical intensive care unit of a single teaching hospital in Korea between May 1 and December 31, 2013, were retrospectively evaluated. RESULTS: A total of 26 potential safety events (5.0%; 95% confidence interval [CI], 3.4%-7.3%) during 520 mobilization sessions were observed in 17 (17.2%; 95% CI, 10.6%-26.4%) of 99 patients. The common potential safety events were as follows in order of frequency: 11 events of tachypnea or bradypnea (2.1%; 95% CI, 1.1%-3.9%), 6 events of desaturation (1.2 %; 95% CI, 0.5%-2.6%), 4 events of tachypnea or bradycardia (0.8%; 95% CI, 0.3%-2.1%), 4 events of patients' intolerance (0.8%; 95% CI, 0.3%-2.1%), and 1 event of tracheostomy tube removal (0.2%; 95% CI, 0%-1.2%). In multivariate analysis, the use of extracorporeal membrane oxygenation was associated with potential adverse events with an adjusted odds ratio of 5.8 (95% CI, 2.2-15.6), respectively. CONCLUSION: Early mobility physical therapy performed by a newly established group was feasible for critically illpatients in Korea. However, potential safety events need to be monitored carefully for patients with extracorporeal membrane oxygenation support.
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