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

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• 作者：Nikki Collings (1) (2) (3)
  Rebecca Cusack (2) (3) (4)
  
  1. Department of Physiotherapy ; University Hospital Southampton NHS Foundation Trust ; Tremona Road ; SO16 6YD ; Southampton ; UK
  2. Anaesthesia and Critical Care Research Unit ; University Hospital Southampton NHS Foundation Trust ; Tremona Road ; SO16 6YD ; Southampton ; UK
  3. Integrative Physiology and Critical Illness Group ; Clinical and Experimental Sciences ; University of Southampton ; University Hospital Southampton ; Tremona Road ; SO16 6YD ; Southampton ; UK
  4. Southampton NIHR Respiratory Biomedical Research Unit ; University Hospital Southampton ; Tremona Road ; SO16 6YD ; Southampton ; UK
  
• 关键词：Critical illness ; Early ambulation ; Exercise ; Oxygen consumption ; Physiotherapy ; Rehabilitation
• 刊名：BMC Anesthesiology
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：15
• 期：1
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  28. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2253/15/1/prepub
  
• 刊物主题：Anesthesiology; Internal Medicine; Emergency Medicine; Intensive / Critical Care Medicine;
• 出版者：BioMed Central
• ISSN：1471-2253

文摘

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