- 作者：Abdulla Damluji ; Jennifer M. Zanni ; Earl Mantheiy ; Elizabeth Colantuoni ; Michelle E. Kho ; Dale M. Needham
- 关键词：Rehabilitation ; Critical care ; Adults ; Mechanical ventilation ; Early mobilization ; Patient safety ; Vascular access device ; Medical complications
- 刊名：Journal of Critical Care
- 出版年：2013
- 出版时间：August, 2013
- 年：2013
- 卷：28
- 期：4
- 页码：535.e9-535.e15
- 全文大小：138 K
Objective
Femoral catheters pose a potential barrier to early rehabilitation in the intensive care unit (ICU) due to concerns, such as catheter removal, local trauma, bleeding, and infection. We prospectively evaluated the feasibility and safety of physical therapy (PT) in ICU patients with femoral catheters.Design, Setting, and Patients
We evaluated consecutive medical ICU patients who received PT with a femoral venous, arterial, or hemodialysis catheter(s) in situ.
Measurements and Main Results
Of 1074 consecutive patients, 239 (22 % ) received a femoral catheter (81 % venous, 29 % arterial, 6 % hemodialysis; some patients had > 1 catheter). Of those, 101 (42 % ) received PT interventions, while the catheter was in situ, for a total of 253 sessions over 210 medical ICU (MICU) days. On these 210 MICU days, the highest daily activity level achieved was 49 (23 % ) standing or walking, 57 (27 % ) sitting, 25 (12 % ) supine cycle ergometry, and 79 (38 % ) in-bed exercises. During 253 PT sessions, there were no catheter-related adverse events giving a 0 % event rate (95 % upper confidence limit of 2.1 % for venous catheters).
Conclusions
Physical therapy interventions in MICU patients with in situ femoral catheters appear to be feasible and safe. The presence of a femoral catheter should not automatically restrict ICU patients to bed rest.