| Popis: |
Background: There is a technical weakness in some ICUs in performing early mobilization protocol (EMP) in patients using vasoactive medications to maintain blood pressure control. Objective: The aim of this trial was to verify if our EMP was safe to use in critical patients with vasoactive medications. Methods: Our EMP separates each patient by the level of clinical complexity through cardiovascular, neurological, respiratory factors and possible intercurrent events prior to the moment of mobilization. We used as definition: 1- FREE: It can be mobilized by a physiotherapist; 2- ATTENTION: It can be mobilized by a physiotherapist accompanied by another member of the ICU team; 3 - RESTRICTED: The mobilization only happens when the managers of ICU team approve. Fourteen critically ill patients in use of vasoactive medications were evaluated. The EMP consist of activities of increasing difficulty: sitting in bed, sitting out of bed, standing and walking. Patient-reported clinical discomfort and low blood pressure were accepted as criteria for discontinuation, since the dose increase of the medications during mobilization is vetoed in the protocol. The primary outcome of this study was the number of patients who needed to interrupt the mobilization process and the number of patients was able to perform all the proposed activities. Results: All the patients perform the EMP. Eleven patients sitting in bed, 9 of then sitting out of bed, 8 of then perform orthotatic position, one patient perform walking training. Conclusion: To increase safety, stratify the patient using clinical complexity was the most important thing in our EMP. |
