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Guarding the Gut: Early Mobility After Abdominal Surgery

Havey, Renee MSN, RN, CCRN; Herriman, Emily BSN, RN, CCRN; O'Brien, Denise DNP, RN, ACNS-BC, FAAN

doi: 10.1097/CNQ.0b013e3182753237
Original Articles

The postoperative period following abdominal surgery presents many challenges to patients and clinicians as recovery progresses and discharge from the intensive care unit approaches. Physiologic changes including the release of inflammatory mediators, increased fatigue and reduction in body mass, and a decline in pulmonary function occurring after abdominal surgery are often potentiated by bed rest and immobility. Evidence-based interventions have the potential to prevent pulmonary complications, wound instability, drain displacement, and orthostatic hypotension. Promoting early mobility is one example of an evidence-based strategy to improve patient outcomes. By understanding the specific needs of the abdominal surgery population, the clinician can safely and effectively implement a mobility plan. The purpose of this article was to briefly review the inflammatory effects associated with bed rest, critical illness, and surgery; review the literature related to mobility in the abdominal surgery patient; describe the effects of immobility on postoperative outcomes; discuss the safety concerns and barriers to mobilization; discuss strategies to overcome barriers; and provide suggestions for application in practice.

Department of Internal Medicine (Ms Havey) and Surgical Intensive Care Unit (Ms Herriman), University of Michigan Health System; Department of Operating Rooms/PACU, University of Michigan Hospitals (Dr O'Brien); and School of Nursing, University of Michigan (Dr O'Brien), Ann Arbor.

Correspondence: Renee Havey, MSN, RN, CCRN, Department of Internal Medicine, University of Michigan Health System, 1500 E Medical Center Dr, UH-6C 6240, Ann Arbor, MI 48109 (

The authors have no financial disclosures.

© 2013 Lippincott Williams & Wilkins, Inc.