MOBILIZING PATIENTS WITH FEMORAL ARTERIAL CATHETHERS DURING PHYSICAL THERAPY
This post is contributed by:
Christiane Perme, PT CCS
Board Certified Cardiovascular and Pulmonary Clinical Specialist
Senior Physical Therapist
The Methodist Hospital, Houston, TX 77030
Rationale: Patients with femoral arterial catheters are on bed rest in intensive care units(ICU) throughout the United States and abroad. Early mobility in ICU increases level of consciousness, improves the psychological well-being, reduces the adverse aspects of immobilization, optimizes functional status and has shown to decrease length of ICU stay.1,2, 3, 4
Methods:This retrospective,single-center, study was conducted in a 40 bed CardioVascular ICU(CVICU) in a teaching hospital. From June 2005 to December 2005,a retrospective chart review was conducted and 30 patients were identified as receiving physical therapy with femoral arterial catheters. All the patients mobilized were alert and hemodynamically stable.
Five activity events were identified: sitting on the side of bed, standing at the bedside, transfer to a stretcher chair, transfer to a regular chair, and walking.
The activity related adverse events included: bleeding at the femoral arterial catheter site, accidental femoral arterial catheter dislodgement and/or removal, non-functioning catheter after activity event, and acute limb ischemia within 24 hours.
Results: There were 134 activity events in the 30 patients identified for this study. The activity events included:
- sitting on the side of bed: 46 (34.3%),
- standing at the bedside: 15 (11.2%),
- transfers to a stretcher chair: 17(12.7%),
- transfers to a regular chair: 28(20.9%), and
- walking: 28 (20.9%).
There were no activity related adverse events documented.
Conclusion: MOBILIZING PATIENTS WITH FEMORAL ARTERIAL CATHETHERS DURING PHYSICAL THERAPY INTERVENTIONS DID NOT LEAD TO CATHETER RELATED COMPLICATIONS. Physical therapy interventions in ICU with focus on early mobility and walking for selected patients with a femoral arterial catheter appears to be feasible. The results of this study have the potential to affect outcomes by reducing the risks associated with bed rest for patients with femoral arterial catheters.
(Presented as abstract at ATS 2009 · San Diego - C S Perme, PT CCS and F N. Masud, MD, FCCP. The Methodist Hospital, Houston, TX, United States)
References:
Perme C, Chandrashekar R. Early mobility and walking program for patients in the intensive care unit:: Creating a standard of care. American Journal of Critical Care. 2009 (in press)
Perme C et al. Early mobilization of LVAD recipients who require prolonged mechanical ventilation. Texas Heart Institute Journal 2006; 33; 130-133
Morris PE et al. Early intensive care unit mobility therapy in the treatment of acute respiratory failure. Crit Care Med. 2008 Aug;36(8):2238-43
Needham DM. Mobilizing patients in the intensive care unit. JAMA.2008;300(14): 1685-1690.
