Early Passive Verticalization in Critically Ill Patients

Cliniques universitaires Saint-Luc- Université Catholique de Louvain10 enrolled

Overview

In the critically patient bed rest and inmovilization are some of the responsable of the development of respiratory complications. Early physical exercise is a tool to prevent respiratory complications as lost of respiratory muscle strength, decrease in functional residual capacity and hypoxemia improving oxygenation. In some cases critically ill conditions implies use of pharmacological sedation. That condition limit the active physical exercise. However, some technicals aids as Tilt table allows execution of passive early movilization. The aim of this study is to assess the effect of early passive verticalization assisted by tilt table on alveolar recruitment and pulmonary ventilation in intensive care unit (ICU) patients, evaluated with electrical impedance tomography (EIT) ICU patients included at day of evaluation will be evaluated consecutively with EIT in three stages; 1) in the supine position (at 30° of inclination), 2) verticalized in tilt table (at 60º of inclination) 3) in the supine position (at 30° of inclination)

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

DIAGNOSTIC

Masking

NONE

Enrollment

Conditions

Critical Illness

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patient admitted at the Intensive Care Medical/Sirurgical Unite of Clinic Saint Luc * Days of hospitalization between 1 and 10 * Hemodynamically stable * Patient or family member sign the informed consent * Sedated patients Exclusion Criteria: * With risk of evisceration * Therapy withdrawal * With cardiac devices (Pace Maker) * Persistent cough * Patches or open wounds in zone of electrodes * Presence of high vasopressor medication (noradrenaline \> 3 mg/h) * PEEP \> 15 cm H2 * Acute Myocardial Infarction * Active bleeding * Intracranial pressure \> 20 mm Hg or with major inestability

Outcomes

Primary Outcomes

Change in pulmonary electric impedance tomography (EIT) before, during and after single session of early passive verticalization

The change in pulmonary recruitment will be evaluated with electrical impedance tomography (EIT) in single session of early passive verticalization. First measure will be made for five minutes with EIT, in bed; second measure will be made during passive verticalization for ten minutes with EIT and last measure will be made after verticalization for twenty minutes with EIT. All impedanciometries obtained in the patient in different activities will compare each.

Time frame: Meassure of EIT during 10 minutes of early passive verticalization and will compared with baseline EIT

Change in PaO2 before, during and after single session of early passive verticalization

Before passive verticalization will be taken a sample of arterial blood gases for determinate the initial PaO2 of the patient. Twenty minutes after passive verticalization will be taken a new sample of arterial blood gases to establish the diference between PaO2 before verticalization and after verticalization

Time frame: Meassure of PaO2 after 20 minutes of passive verticalization and will compared with baseline PaO2