Ambulating With Pulmonary Artery or Femoral Catheters in Place

Winkelman, Chris

doi:10.4037/ccn2011556

Cited by 11 publications

(4 citation statements)

References 21 publications

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“…Cannulation of arterial and venous femoral vessels has been identified as a potential and actual barrier to hip flexion, sitting, standing and walking for patients in the intensive care unit (ICU). [1][2][3][4][5] Femoral arterial catheterization for hemodynamic monitoring is the most commonly used location after the radial artery, particularly in medical ICU settings. 6 Venous access is used to administer medications or fluid, allow blood sampling, monitor pressure, and provide access for dialysis.…”

Section: Introductionmentioning

confidence: 99%

Safety and Efficacy of Mobility Interventions in Patients with Femoral Catheters in the ICU: A Prospective Observational Study

Perme

Nalty²,

Winkelman³

et al. 2013

Cardiopulmonary Physical Therapy Journal

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Introduction: There are limited data describing mobility interventions provided to patients with femoral catheters. The purpose of this study was to examine the incidence of femoral catheter related adverse effects during physical therapy (PT) sessions in a cardiovascular intensive care unit (ICU). Methods: This was a prospective, observational study and included patients with at least one femoral catheter. Data were collected after each PT session. Results: There were 77 subjects with a total of 92 femoral catheters (50 arterial, 15 central venous, and 27 dialysis) treated. A total of 210 separate PT sessions occurred with 630 mobility activities including sitting on side of bed, standing at the bedside, transfers to stretcher chair or regular chair, and walking. There were no catheter related mechanical or thrombotic complications during any of the PT sessions. Conclusions: Physical therapy sessions, including standing and walking were feasible and safe in cardiovascular ICU patients with femoral catheters who met the criteria for mobility interventions. The results from this study support the hypothesis that early mobilization in patients with femoral catheters is important to minimize functional decline and provide evidence that the presence of femoral catheters alone should not be a reason to limit progressive mobility interventions.

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Section: Introductionmentioning

confidence: 99%

Safety and Efficacy of Mobility Interventions in Patients with Femoral Catheters in the ICU: A Prospective Observational Study

Perme

Nalty²,

Winkelman³

et al. 2013

Cardiopulmonary Physical Therapy Journal

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“…However, safety concerns for patients attached to the aforementioned devices are being disproved in the literature. 9,45,48 As you will read throughout this issue of Critical Care Nursing Quarterly, medical devices should not limit a patient's functional progression within a 44 CRITICAL CARE NURSING QUARTERLY/JANUARY-MARCH 2013 mobility framework. 12,14,15 Rather, evidence supports mobilization despite these traditionally activity-restricted treatments.…”

Section: Adapt Care Around Technologymentioning

confidence: 98%

Building a Protocol to Guide Mobility in the ICU

Dammeyer

Dickinson

Packard

et al. 2013

Critical Care Nursing Quarterly

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Professional experience and wisdom have taught us that immobility is a risk factor for various adverse outcomes, such as deep vein thrombosis, joint contractures, pulmonary dysfunction, and bone demineralization to name a few. Balancing bed rest and mobility may improve both short- and long-term outcomes for our patients. Moreover, early, routine mobilization of critically ill patients is safe and reduces hospital length of stay, shortens the duration of mechanical ventilation, improves muscle strength, and functional independence. At the University of Michigan, we have turned the tides by creating a structured process to get our patients moving through the use of a standardized mobility protocol. Our protocol is simple and can easily be adapted for all patient populations by simply modifying some of the inclusion and exclusion criteria. The activities are grounded in the evidence and well thought out to prevent complications and promote mobilization. The purpose of this article was to present the science behind the development of a multidisciplinary protocol for early mobilization of critically ill patients that can be adapted to any intensive care unit patient with minor modifications.

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“…5 Finally, it has been suggested that potential complications from positional changes with an indwelling PAC include catheter fracture, movement within the pulmonary artery causing injury to the vessel or accidental dislodgment into the right ventricle, dysrhythmias, and infarction or rupture of pulmonary artery. 6 This suggestion, however, has not been addressed with an evidence-based approach.…”

Section: Introductionmentioning

confidence: 99%

“…Related studies include exercise research studies where PACs were used to measure hemodynamic stability and exercise response as subjects: sat, marched in place, transferred to a bedside chair, ambulated, climbed stairs and completed exercises stress tests, all without PAC complications reported. 12–16 Expert opinion regarding the relationship between patient activity and PAC dysfunction states “although no specific report has been published about the safety of sitting or walking ICU patients who have pulmonary artery catheters, the literature does appear to support both the feasibility and safety in practice.” 6 Finally there have been similar concerns about potential complications caused by changes in position and mobility activities with femoral artery catheters. A retrospective case series reported that no adverse events were documented in physical therapy sessions in which patients with femoral arterial catheters performed mobility activities including sitting edge of bed, standing, transferring to a chair, and walking.…”

Section: Introductionmentioning

confidence: 99%

Mobility and Ambulation for Patients With Pulmonary Artery Catheters

Fields

Trotsky

Fernández

et al. 2015

Journal of Acute Care Physical Therapy

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Purpose The purposes of this retrospective study are to: 1) describe the amount and type of documented mobility activity for patients with an indwelling Pulmonary Artery Catheter (PAC) and 2) document the frequency and type of complications that occur with an indwelling PAC during patient participation in these activities. Methods This study is a single-center, retrospective, descriptive study including all patients (>18 years) between June 2010 and October 2012 with an indwelling PAC in the Cardiology Intensive Care Unit (CICU). Data was extracted on all documented mobility activity each of these patients performed with nursing or during skilled treatments provided by a physical therapist (PT), or occupational therapist (OT). Any notation of PAC-related complications while the PAC was in place was recorded. Results In the CICU over a 29-month period, 366 patients with indwelling PACs performed bed mobility, transfers, ambulation and climbed stairs with no reports of PAC complications during or in relation to participation in mobility activity. Conclusion The data suggests that participation in mobility activities does not place patients with an indwelling PAC at increased risk of PAC related complications. This data further supports the involvement of rehabilitation specialists in the CICU. Future prospective research is necessary to measure the effects of physical therapy treatment on patients with indwelling PAC.

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Ambulating With Pulmonary Artery or Femoral Catheters in Place

Cited by 11 publications

References 21 publications

Safety and Efficacy of Mobility Interventions in Patients with Femoral Catheters in the ICU: A Prospective Observational Study

Safety and Efficacy of Mobility Interventions in Patients with Femoral Catheters in the ICU: A Prospective Observational Study

Building a Protocol to Guide Mobility in the ICU

Mobility and Ambulation for Patients With Pulmonary Artery Catheters

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