Passive exercise of the lower limbs and trunk alleviates decreased intestinal motility in patients in the intensive care unit after cardiovascular surgery

Abstract

[Purpose] The purpose of this study was to clarify the effects of passive exercise of the lower limbs and trunk (PELT) in ICU patients after cardiovascular surgery with decreased bowel motility. [Subjects and Methods] Ten ICU patients with clinically-apparent decreased bowel motility during the period of April to July 2016 were enrolled this study. Bowel sounds (BS) for 5 minutes at rest and 5 minutes after PELT were recorded through an electronic stethoscope. A frequency analysis was performed and the BS before and after PELT were compared. In addition, the percent change in BS before and after PELT was determined, and the relationship between the percent change in BS and individual parameters (invasiveness of surgery, inflammation, nutrition, renal function) was examined. [Results] Average BS (integral value) for 5 minutes before and after PELT were 63.1 ± 41.3 mVsec and 115.0 ± 57.8 mVsec, respectively; therefore, BS was significantly increased by PELT. When compared to patients at rest, a significant increase was found 0–4 minutes after PELT. None of the individual parameters was significantly correlated with the percent change. [Conclusion] PELT can increase the bowel motility of ICU patients with decreased bowel motility.

The Pharmacokinetics of Sildenafil May Be Affected by Intestinal Absorption Rate in Children Admitted to the Intensive Care Unit

“…That is, the integral value of bowel sounds after 5 min at rest was 63.1 ± 41.3 mVsec and that 5 min after PELT was 115.0 ± 57.8 mVsec, suggesting that the resting state had a considerable suppressive effect on the gastrointestinal motility. 19) These reports strongly support our hypothesis that the first-pass hepatic extraction of SIL was increased by the prolonged and sustained intestinal absorption of the drug under ICU conditions.…”

“…[15][16][17][18] The determinants of gastrointestinal complications in cardiac surgery were the use of anesthetic drugs 15) , mechanical ventilation 16) , and increased activity in the sympathetic nerve. 17) In addition, Morisawa et al 19) reported that decreased intestinal motility in patients in the ICU after cardiovascular surgery can be corrected by passive exercise of the lower limbs and trunk (PELT). That is, the integral value of bowel sounds after 5 min at rest was 63.1 ± 41.3 mVsec and that 5 min after PELT was 115.0 ± 57.8 mVsec, suggesting that the resting state had a considerable suppressive effect on the gastrointestinal motility.…”

Automated Bowel Sound Analysis: An Overview

“…The insufficient reliability of clinical auscultation prompted Dumas et al to construct a system for continuous BS monitoring in neonates; a single stethoscope was used, attached with a hydrogel patch for over 3 h. The authors suggested that a BS vital sign is needed and that a real-time analysis could help guide automatic feeding pumps [ 124 ]. BS recorded with a single stethoscope were used to investigate the efficacy of exercises on bowel motility [ 125 , 126 ]. Kusainov and Makukha demonstrated that a microelectromechanical system microphone may be used in an electronic stethoscope [ 127 ].…”

Early exercise in intensive care units in China: nurses’ current practices, limitations and intentions

“…Early exercise for critically ill patients usually includes in-and out-of-bed exercises. It was reported that continuous in-bed exercise was considered safe and beneficial for ICU patients, 33,34 and out-of-bed exercise is more important to promote the recovery of critical patients than in-bed exercise. 35,36 However, this study found that out-of-bed mobilization was not well implemented, which was similar to the results of the studies conducted in Australia and New Zealand, 37 Germany, 38 and the United States.…”