A repeated measures, randomised cross-over trial, comparing the acute exercise response between passive and active sitting in critically ill patients

BMC Anesthesiology

Nikki Collings¹  Rebecca Cusack² 

[1] Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, University of Southampton, University Hospital Southampton, Tremona Road, SO16 6YD Southampton, UK

[2] Southampton NIHR Respiratory Biomedical Research Unit, University Hospital Southampton, Tremona Road, SO16 6YD Southampton, UK

关键词: Rehabilitation;    Physiotherapy;    Oxygen consumption;    Exercise;    Early ambulation;    Critical illness;   

Others  :  1088999
DOI  :  10.1186/1471-2253-15-1

 received in 2014-10-03, accepted in 2015-01-02,  发布年份 2015

【 摘 要 】

Background

Early mobilisation of critically ill patients is safe and beneficial, but the metabolic cost of exercise remains unquantified. This study compared the acute exercise response in critically ill participants during passive and active sitting.

Method

We conducted a prospective, randomised, cross-over study, in ventilated patients receiving rehabilitative physiotherapy. Ten participants completed a passive chair transfer, or a sit on the edge of the bed, followed by the alternate exercise activity on the consecutive day. The primary outcome measure was oxygen consumption.

Results

In comparison to resting supine, a passive chair transfer elicited no change in oxygen consumption, carbon dioxide production or minute ventilation; but mean arterial pressure (91.86 mmHg (95% CI 84.61 to 99.10) to 101.23 mmHg (95% CI 93.35 to 109.11) (p = 0.002)) and heart rate (89.13 bpm (95% CI 77.14 to 101.13) to 97.21 bpm (95% CI 81.22 to 113.20) (p = 0.008)) increased. Sitting on the edge of the bed resulted in significant increases in oxygen consumption (262.33 ml/min (95% CI 201.97 to 322.70) to 353.02 ml/min (95% CI 303.50 to 402.55), p = 0.002), carbon dioxide production (171.93 ml/min (95% CI 131.87 to 211.98) to 206.23 ml/min (95% CI 151.03 to 261.43), p = 0.026), minute ventilation (9.97 l/min (95% CI 7.30 to 12.65) to 12.82 l/min (95% CI 10.29 to 15.36), p < 0.001), mean arterial pressure (86.81 mmHg (95% CI 77.48 to 96.14) to 95.59 mmHg (95% CI 88.62 to 102.56), p = 0.034) and heart rate (87.60 bpm (95% CI 73.64 to 101.56) to 94.91 bpm (95% CI 79.57 to 110.25), p = 0.007). When comparing the 2 activities, sitting on the edge of the bed elicited a significantly larger increase in oxygen consumption (90.69 ml/min (95% CI 44.04 to 137.34) vs 14.43 ml/min (95% CI -27.28 to 56.14), p = 0.007) and minute ventilation (2.85 l/min (95% CI 1.70 to 3.99) vs 0.74 l/min (95% CI -0.92 to 1.56), p = 0.012).

Conclusion

Sitting on the edge of the bed is a more metabolically demanding activity than a passive chair transfer in critically ill patients.

【 授权许可】

   
2015 Collings and Cusack; licensee BioMed Central.

【 图 表 】

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