Ruy Camargo Pires-Neto1, Natalia Pontes Lima2, Gregorio Marques Cardim2, Marcelo Park3, Linda Denehy4. 1. Department of Pathology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil. Electronic address: ruy@usp.br. 2. Physiotherapy Service, Instituto Central do Hospital das Clínicas da Faculdade de Medicina de São Paulo, São Paulo, SP, Brazil. 3. Intensive Care Unit, Clinical Emergency Department, Instituto Central do Hospital das Clínicas da Faculdade de Medicina de São Paulo, São Paulo, SP, Brazil. 4. Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Parkville, Melbourne, Australia.
Abstract
OBJECTIVES: To characterize the provision of early mobilization therapy in critically ill patients in a Brazilian medical intensive care unit (ICU) and to investigate the relationship between physical activity level and clinical outcomes. METHODS: Intensive care unit and physiotherapy data were collected retrospectively from 275 consecutive patients. Here we report on the subset of patients (n = 120) who were mechanically ventilated during their ICU stay (age, 49 ± 18 years; Simplified Acute Physiology Score 3, 45 [25]). RESULTS: Median (interquartile range) time of mechanical ventilation and ICU length of stay were 3 (4) and 8 (10) days, respectively. Intensive care unit and 1-year mortality were 31% and 50%, respectively. During the ICU stay, these patients all received respiratory physiotherapy and 90% (n = 108) received mobilization therapy. When intubated and ventilated, mobilization therapy was performed in 76% (n = 92) of the patients with no adverse events. The most common activity was in-bed exercises (55%), and the number of out-of-bed activities (sitting out of bed, standing, or walking) was small (29%) and more prevalent in patients with tracheostomy than with an endotracheal tube (27% × 2%, respectively). CONCLUSION: In our Brazilian ICU, mobilization therapy in critically ill patients was safe and feasible; however, similar to other countries, in-bed exercises were the most prevalent activity. During mechanical ventilation, only a small percentage of activities involved standing or mobilizing away from the bed.
OBJECTIVES: To characterize the provision of early mobilization therapy in critically illpatients in a Brazilian medical intensive care unit (ICU) and to investigate the relationship between physical activity level and clinical outcomes. METHODS: Intensive care unit and physiotherapy data were collected retrospectively from 275 consecutive patients. Here we report on the subset of patients (n = 120) who were mechanically ventilated during their ICU stay (age, 49 ± 18 years; Simplified Acute Physiology Score 3, 45 [25]). RESULTS: Median (interquartile range) time of mechanical ventilation and ICU length of stay were 3 (4) and 8 (10) days, respectively. Intensive care unit and 1-year mortality were 31% and 50%, respectively. During the ICU stay, these patients all received respiratory physiotherapy and 90% (n = 108) received mobilization therapy. When intubated and ventilated, mobilization therapy was performed in 76% (n = 92) of the patients with no adverse events. The most common activity was in-bed exercises (55%), and the number of out-of-bed activities (sitting out of bed, standing, or walking) was small (29%) and more prevalent in patients with tracheostomy than with an endotracheal tube (27% × 2%, respectively). CONCLUSION: In our Brazilian ICU, mobilization therapy in critically illpatients was safe and feasible; however, similar to other countries, in-bed exercises were the most prevalent activity. During mechanical ventilation, only a small percentage of activities involved standing or mobilizing away from the bed.