The effects of mobilization programs on cardiopulmonary system in critically ill patients

Aim: The aim of this study is to asses cardiopulmonary responses constituted by mobilizationprograms in the critically ill patients with different clinic diagnosis.Method: This study was conducted in the Anestesiology and Reanimation Intensive CareUnit. Mobilization program was formed in 5 stages. These stages were as follows: sitting inthe bed with support for 3 min (first stage), sitting over the edge of the bed for 3 min with nosupport (second stage), standing with support (third stage), walking about 10 meters withsupport (forth stage), and sitting on a chair with support for 3 min (fifth stage).As for respiratory parameters; respiratory rate, saturation of peripheral oxygen (SpO2) and theratio of partial pressure of arterial oxygen to fraction of inspired oxygen (PaO2/FiO2) wererecorded. Hemodynamic parameters; including heart rate, systolic, diastolic and mean bloodpressure were also recorded and analyzed.Heart rate, systolic, diastolic and mean blood pressure, respiratory rate, SpO2 were measuredprior to, during and after mobilization. The PaO2/FiO2 ratio which is indicator of oxygenationwas calculated from arterial blood gas before and 30 minutes after the mobilization.Results: Forty critically ill patients were taken in this study. In the 20 patients who were ableto complete the five grades of the mobilization program, during the supported standing andwalking stages of the mobilizations, the heart and respiratory rate statistically significantincreased considering those prior to the mobilization (p<0.05). These changes did not requireany specific intervention and no further increases were observed in these parameters beyondwalking when the activity was progressed to supported sitting on the chair (p>0.05). It wasdetermined that there was a statistically increase in the PaO2/FiO2 ratio followingmobilization (p<0.05).Conclusion: The changes in heart and respiratory rates during standing and walking withsupport and the improvement in oxygenation following mobilization were considered asphysiologic responses due to positional changes. We think that mobilization can beperformed safely in critically ill patients as a standard before, during and after themobilization of cardiopulmonary parameters on condition that they are monitored.