Safe Ambulation of Critically Ill Cardiac Patients With Femoral Balloon Pumps: A Case Cohort Study

Ramsey, Stephen Cameron; Lucas, Jason; Barrett, Peter; Ballard, William L.; Kaul, Prashant; Klein, Andrew J.

doi:10.1016/j.cardfail.2020.05.010

Cited by 12 publications

(21 citation statements)

References 5 publications

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“…In addition, ambulation sessions were well tolerated with no incidences of device dislodgement or migration during any ambulation session. Our results are similar to those reported by Ramsey et al 7 who created the original Ramsey protocol. Ramsey et al 7 reported IABP site infection in three patients with two of the infections occurring 3-5 days after IABP migration and repositioning, suggesting that IABP manipulation and prolonged support duration contribute to infection risk.…”

Section: Discussionsupporting

confidence: 92%

“…Our results are similar to those reported by Ramsey et al . 7 who created the original Ramsey protocol. Ramsey et al .…”

Section: Discussionmentioning

confidence: 99%

“…Our ambulation protocol is similar to the original Ramsey protocol that has been previously described, with slight modifications to incremental angle elevation and lowering of the tilt table during patient transfer from the supine to upright positions. 7 Before mobilization, physical examination was performed to evaluate lower extremity perfusion, and a chest radiograph was obtained to confirm IABP position. Once a patient was identified as a candidate for ambulation, a multidisciplinary team consisting of the treating physician, advanced practice provider, registered nurse, and physical therapists was assigned designated roles to ensure patient safety.…”

Section: Methodsmentioning

confidence: 99%

“…To mitigate the morbidity associated with prolonged bed rest in patients with femoral IABPs, a critical care physical therapist developed a protocol known as the Ramsey protocol to allow for early ambulation. 7 The purpose of this study was to determine the safety and feasibility of implementing a modified Ramsey protocol in a cohort of patients with femoral IABPs as a BTT at our institution.…”

mentioning

confidence: 99%

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Safety and Feasibility of an Early Mobilization Protocol for Patients with Femoral Intra-Aortic Balloon Pumps as Bridge to Heart Transplant

et al. 2021

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Intra-aortic balloon pumps (IABPs) can be used to provide hemodynamic support in patients with end-stage heart failure as a bridge to transplantation (BTT). The IABP is commonly inserted via the common femoral artery, which can limit patients’ mobility. The Ramsey protocol, developed by a critical care physical therapist, allows patients with femoral IABPs to ambulate with the assistance of a tilt table. The aim of this study was to determine the safety and feasibility of a modified Ramsey protocol for early mobilization of patients with femoral IABPs as BTT. This is a retrospective single-center review of patients with femoral IABPs as BTT using a tilt table protocol from May 2019 to May 2020. Primary outcomes were time to successful ambulation, number of successful ambulation events, and ambulation-associated adverse events, including IABP augmentation, waveform, positioning changes, and vascular complications at the insertion site. Twenty-four patients (mean age 55 ± 16 years) underwent femoral IABP insertion as BTT and were mobilized following our protocol. Nineteen patients (79.2%) successfully ambulated with a median of three sessions (interquartile range, 2–4) per patient. The median time from IABP insertion to ambulation was 3 days (interquartile range, 2–5). Twenty-one patients underwent heart transplantation, of which all 19 who ambulated were successfully bridged to transplantation. Early mobilization in select patients with femoral IABPs can be performed safely and successfully, avoiding the deleterious effects of bed rest that have been historically seen in this patient population.

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Section: Discussionsupporting

confidence: 92%

“…Our results are similar to those reported by Ramsey et al . 7 who created the original Ramsey protocol. Ramsey et al .…”

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Safety and Feasibility of an Early Mobilization Protocol for Patients with Femoral Intra-Aortic Balloon Pumps as Bridge to Heart Transplant

et al. 2021

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“…Exercise intervention is terminated when patients have hemodynamic instability, hypoxemia, dizziness, weakness, chest pain, or dyspnea 62) . It is worth noting that for individuals with femoral access to mechanical circulatory support devices, movements that require hip flexion over 30 degrees or overextend the leg should be avoided to decrease the risk of malpositioning 65) . Kerrigan et al reported that 6 weeks of aerobic training (walking/cycling at 60%–80% HRR, 30 minutes/session, 3 sessions/week) improves cardiorespiratory fitness, muscle strength, and QoL of individuals who receive continuous flow LVAD implantation within 6 months 66) .…”

Section: Physical Therapy For Individuals With Hfmentioning

confidence: 99%

Physical Therapy for Adults with Heart Failure

CHEN

2023

Phys Ther Res

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Heart failure (HF) is a complex clinical syndrome caused by structural and/or functional abnormalities that results in significant disease burdens not only to the patients and their families but also to the society. Common symptoms/signs of HF include dyspnea, fatigue, and exercise intolerance, which significantly reduce the quality of life of individuals. Since the coronavirus disease 2019 (COVID-19) pandemic in 2019, it has been found that individuals with cardiovascular disease are more vulnerable to COVID-19-related cardiac sequelae including HF. In this article, we review the updated diagnosis, classifications, and interventional guidelines of HF. We also discuss the link between COVID-19 and HF. The latest evidence about physical therapy for patients with HF in both the stable chronic phase and acute cardiac decompensation phase is reviewed. Physical therapy for HF patients with circulatory support devices is also described.

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Temporary mechanical circulatory support: Devices, outcomes, and future directions

Baran

Jaiswal

Hennig

et al. 2022

The Journal of Heart and Lung Transplantation

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Safe Ambulation of Critically Ill Cardiac Patients With Femoral Balloon Pumps: A Case Cohort Study

Cited by 12 publications

References 5 publications

Safety and Feasibility of an Early Mobilization Protocol for Patients with Femoral Intra-Aortic Balloon Pumps as Bridge to Heart Transplant

Safety and Feasibility of an Early Mobilization Protocol for Patients with Femoral Intra-Aortic Balloon Pumps as Bridge to Heart Transplant

Physical Therapy for Adults with Heart Failure

Temporary mechanical circulatory support: Devices, outcomes, and future directions

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