Impact of mobilisation therapy on the haemodynamic and respiratory status of elderly intubated patients in an intensive care unit: A retrospective analysis

Intensive Crit Care Nurs. 2016 Aug:35:16-21. doi: 10.1016/j.iccn.2016.02.001. Epub 2016 Mar 5.

Abstract

Objectives: This study identified respiratory and haemodynamic parameters affected by limited mobilisation therapy in elderly, critically ill, intubated patients in an intensive care unit.

Methods: Over 18 months, we retrospectively assessed physiological changes during 43 mobilisation therapy sessions in 23 patients requiring mechanical ventilation for >48h. We compared heart rate, mean arterial blood pressure, respiratory rate, partial pressure of oxygen in arterial blood/inspired fraction of oxygen and lactate before and after mobilisation therapy, which entailed sitting on the edge of a hospital bed without back support. We analysed baseline characteristics and therapy duration.

Results: Patients' median age was 75 (interquartile range: 65-79) years, and the median Acute Physiology and Chronic Health Evaluation II score was 27 (26-31). Average therapy duration was 1h (0.5-2h). Therapy did not significantly modify heart rate or arterial blood pressure but increased the partial pressure of oxygen in arterial blood/inspired fraction of oxygen ratio significantly, from 218.8 (135.4-271.7) to 237.3 (167.2-284.9; p=0.007), indicating improved lung function.

Conclusion: In this retrospective review, mobilisation therapy had no adverse effect on elderly, critically ill, intubated patients' haemodynamic status and appeared to improve the PaO2/FIO2 ratio; further research is required to confirm this finding.

Keywords: Haemodynamics; Intensive care unit; Lung function; Mobilisation.

MeSH terms

  • Aged
  • Female
  • Health Status*
  • Hemodynamics / physiology
  • Humans
  • Intensive Care Units / organization & administration
  • Intubation, Intratracheal / adverse effects
  • Male
  • Patient Positioning / methods*
  • Patient Positioning / nursing
  • Patient Positioning / standards*
  • Respiratory System / physiopathology
  • Retrospective Studies