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Copyright © 2018 Academy of Acute Care Physical Therapy, APTA.
Unauthorized reproduction of this article is prohibited.
JACPT ■ Volume 00 ■ Number 00 ■ 2018 1
ORIGINAL
STUDY
Journal of Acute Care Physical Therapy
Clara H. Gaspari, PT, DPT, NCS
Department of Physical Therapy,
Instituto Estadual do Cérebro Paulo
Niemeyer, Rio de Janeiro, RJ, Brazil.
cgaspari@gmail.com.
Sabrina Lafayette, PT
Department of Physical Therapy,
Instituto Estadual do Cérebro Paulo
Niemeyer, Rio de Janeiro, Brazil.
Anna Carolina Jaccoud, PT
Department of Physical Therapy,
Instituto Estadual do Cérebro Paulo
Niemeyer, Rio de Janeiro, Brazil.
Pedro Kurtz, MD, PhD
Department of Neurointensive Care,
Instituto Estadual do Cérebro Paulo
Niemeyer, Rio de Janeiro, Brazil.
Luiz A. Lavradas Jr, MD
Department of Neurosurgery, Instituto
Estadual do Cérebro Paulo Niemeyer,
Rio de Janeiro, Brazil.
Daniel D. Cavalcanti, MD, PhD
Department of Neurosurgery, Instituto
Estadual do Cérebro Paulo Niemeyer,
Rio de Janeiro, Brazil.
The authors have no conflicts of inter-
est and no source of funding to declare.
A portion of this study was presented at
the 2017 Combined Sections Meeting
of the American Physical Therapy Asso-
ciation, in San Antonio, Texas in 2017.
ABSTRACT
Introduction: Prolonged bed rest is a frequent problem for patients with
critical illness that may negatively impact survival, quality of life, and medical
care cost. Patients with critical neurologic problems are often kept on bed
rest or only cleared to perform bed-based activities because of the inherent
risk of displacing or damaging intracranial monitoring devices such as the
external ventricular drains (EVDs) during activity. Specific recommendations
for out-of-bed (OOB) mobilization of such patients are lacking.
Purpose: To review the occurrence of adverse events related to OOB
mobilization in patients with EVDs.
Methods: This was a retrospective study. Data from all adult patients
with an EVD and medical clearance for OOB physical therapy (PT) from
October 2014 to November 2016 were analyzed.
Results: Eighteen patients with EVDs received 108 interventions of OOB PT
sessions during this period. No catheter-related mechanical complications
occurred during or immediately following the sessions. No serious adverse
events were recorded. Minor adverse events included transient dizziness,
headache, episodes of hypertension, and hypotension. Vital signs showed
no clinically relevant variations before and after the sessions.
Conclusions: OOB mobilization was feasible and safe in this group
of patients. The effect on morbidity and survival should be further
investigated in a larger prospective study.
DOI: 10.1097/JAT.0000000000000085
Copyright © 2018 Academy of Acute Care Physical Therapy, APTA.
Safety and Feasibility of
Out-of-Bed Mobilization
for Patients With External
Ventricular Drains in a
Neurosurgical Intensive
Care Unit
Clara H. Gaspari, Sabrina Lafayette, Anna Carolina Jaccoud,
Pedro Kurtz, Luiz A. Lavradas Jr, Daniel D. Cavalcanti