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Mobilization of Intensive Care Cardiac Surgery Patients on Mechanical Circulatory Support

Freeman, Regi MSN, RN, CNS; Maley, Kimberly BSN, RN

Critical Care Nursing Quarterly:
doi: 10.1097/CNQ.0b013e31827532c3
Original Articles
Abstract

Historically, intensive care cardiac surgery patients remained on bed rest for several days postoperatively to prevent complications and promote rest and healing. Over time, the cardiac surgery discipline has acknowledged the benefits of early mobility, including reduced risk of venous thromboembolism and pulmonary emboli, improved pulmonary toilet, prevention of pneumonia, decreased length of stay, reduced deconditioning, and need for rehabilitation, among others advantages. These benefits have changed clinical practice, with emphasis on early extubation, progressive mobility, and reduced lengths of stay. Early mobility is a staple in postoperative intensive care of cardiac surgery patients. Patient mobility practices include range of motion, dangling at the bedside, and transition to the chair on the operative day, if able. Postoperative day 1 entails transferring from the bed to the chair 2 to 3 times and, if feasible, ambulation in the room and hallway. Patients with pulmonary artery catheters, arterial lines, chest tubes, and mechanical circulatory support devices are included in early progressive mobility to prevent postoperative complications. This article will discuss early progressive mobility in cardiovascular intensive care unit patients, with a focus on specific considerations for patients post–cardiac surgery and those with mechanical circulatory support devices.

Author Information

Cardiovascular Intensive Care Unit and Cardiac & Thoracic Surgery Unit (Ms Freeman), and Cardiovascular Intensive Care Unit (Ms Maley), University of Michigan Health System, Ann Arbor, Michigan.

Correspondence: Regi Freeman, MSN, RN, CNS, Cardiovascular Intensive Care Unit and 4C Cardiac & Thoracic Surgery Unit, Cardiovascular Center ICU 4726C, University of Michigan Health System, 1500 E. Medical Center Dr, Ann Arbor, MI 48109 (colthorp@med.umich.edu).

Special thanks to the CVICU nurses, techs, physical and occupational therapists, respiratory therapists, nurse practitioners, and physicians at the University of Michigan CVICU who assist with the care and mobilization of our critically ill cardiovascular surgery patients each day. Your dedication to our patients' progressive mobility, ability to think outside the box, and desire to push the limits of what has been done historically continue to make us “the leaders and the best.”

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

© 2013 Lippincott Williams & Wilkins, Inc.