Impact of Early Mobilization Within the Intensive Care Unit After Coronary Artery Bypass Grafting: A Systematic Review

Cardiopulmonary physical therapy journal Pub Date : 2024-03-26 DOI:10.1097/cpt.0000000000000244

Bini Thomas, Sandra P. Morgan, James M. Smith

{"title":"Impact of Early Mobilization Within the Intensive Care Unit After Coronary Artery Bypass Grafting: A Systematic Review","authors":"Bini Thomas, Sandra P. Morgan, James M. Smith","doi":"10.1097/cpt.0000000000000244","DOIUrl":null,"url":null,"abstract":"\n \n Coronary artery bypass grafting (CABG) surgery treats complications from coronary artery diseases, and its recovery traditionally consisted of bedrest. Recent research emphasizes the benefits of early mobilization for hospitalized patients. However, the functional outcomes and effectiveness of early mobilization for persons within the intensive care units after CABG has not been investigated thus far. The objective of this review was to determine the effectiveness of early mobilization in reducing hospital and intensive care unit length of stay (LoS) and improving functional outcomes of persons after CABG.\n \n \n \n This study was registered with PROSPERO and followed PRISMA guidelines. PubMed, Embase, CINAHL, and PEDro databases were searched using MeSH terms. Studies with early mobilization interventions for adults in the intensive care unit after CABG that recorded outcomes of LoS or functioning were included. Methodological quality was measured using the PEDro scale and Oxford Level of Evidence.\n \n \n \n This systematic review collectively addressed 2280 participants through 14 studies in 7 countries. The initiation time frames for early mobilization varied, with the majority beginning within 24 to 48 hours after surgery and interventions were heterogenous. Early mobility was found to be effective in reducing atelectasis, improving oxygen saturation, and decreasing time spent on mechanical ventilation. Among early mobilization participants, the LoS was reduced in all studies; intensive care unit LoS decreased by one day or greater in 6 of 14 studies, and hospital LoS decreased by one day or greater in 5 of 7 studies.\n \n \n \n Data analysis found that early mobilization achieved better functional outcomes. It was found that implementing early mobilization led to decreased intensive care and hospital lengths of stay, reduced atelectasis and pleural effusion, and improved functional and respiratory outcomes in persons who underwent CABG surgery.\n","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"104 35","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiopulmonary physical therapy journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/cpt.0000000000000244","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 0

Abstract

Coronary artery bypass grafting (CABG) surgery treats complications from coronary artery diseases, and its recovery traditionally consisted of bedrest. Recent research emphasizes the benefits of early mobilization for hospitalized patients. However, the functional outcomes and effectiveness of early mobilization for persons within the intensive care units after CABG has not been investigated thus far. The objective of this review was to determine the effectiveness of early mobilization in reducing hospital and intensive care unit length of stay (LoS) and improving functional outcomes of persons after CABG. This study was registered with PROSPERO and followed PRISMA guidelines. PubMed, Embase, CINAHL, and PEDro databases were searched using MeSH terms. Studies with early mobilization interventions for adults in the intensive care unit after CABG that recorded outcomes of LoS or functioning were included. Methodological quality was measured using the PEDro scale and Oxford Level of Evidence. This systematic review collectively addressed 2280 participants through 14 studies in 7 countries. The initiation time frames for early mobilization varied, with the majority beginning within 24 to 48 hours after surgery and interventions were heterogenous. Early mobility was found to be effective in reducing atelectasis, improving oxygen saturation, and decreasing time spent on mechanical ventilation. Among early mobilization participants, the LoS was reduced in all studies; intensive care unit LoS decreased by one day or greater in 6 of 14 studies, and hospital LoS decreased by one day or greater in 5 of 7 studies. Data analysis found that early mobilization achieved better functional outcomes. It was found that implementing early mobilization led to decreased intensive care and hospital lengths of stay, reduced atelectasis and pleural effusion, and improved functional and respiratory outcomes in persons who underwent CABG surgery.

查看原文本刊更多论文

冠状动脉旁路移植术后重症监护病房内早期动员的影响：系统回顾

冠状动脉旁路移植术（CABG）是治疗冠状动脉疾病并发症的手术，其恢复过程传统上需要卧床休息。最近的研究强调了住院患者早期康复的益处。然而，迄今为止，尚未对 CABG 术后重症监护病房患者的功能结果和早期康复的有效性进行调查。本综述旨在确定早期动员在缩短住院时间和重症监护病房住院时间（LoS）以及改善心血管手术后患者功能预后方面的有效性。本研究已在 PROSPERO 注册，并遵循了 PRISMA 指南。使用 MeSH 术语对 PubMed、Embase、CINAHL 和 PEDro 数据库进行了检索。纳入的研究包括对 CABG 术后重症监护室中的成人进行早期动员干预，并记录了 LoS 或功能的结果。方法学质量采用 PEDro 量表和牛津证据等级进行衡量。该系统性综述共涉及 7 个国家的 14 项研究的 2280 名参与者。早期移动的启动时间各不相同，大多数在术后24至48小时内开始，干预措施也不尽相同。研究发现，早期动员能有效减少肺不张、提高血氧饱和度并缩短机械通气时间。在所有研究中，早期移动参与者的LoS都有所减少；在14项研究中，有6项研究的重症监护室LoS减少了一天或更多，在7项研究中，有5项研究的住院LoS减少了一天或更多。数据分析发现，早期动员可获得更好的功能性结果。研究发现，实施早期动员可缩短重症监护和住院时间，减少肺不张和胸腔积液，改善接受 CABG 手术患者的功能和呼吸预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Cardiopulmonary physical therapy journal

自引率

0.00%

发文量