First initiation of mobilization out of bed after cardiac surgery - an observational cross-sectional study in Sweden

• Published in: Journal of cardiothoracic surgery 2024-07, Vol.19 (1), p.420-9, Article 420
• Main Authors: Westerdahl, Elisabeth, Lilliecrona, Johanna, Sehlin, Maria, Svensson-Raskh, Anna, Nygren-Bonnier, Malin, Olsen, Monika Fagevik
• Format: Article
• Language: English
• Subjects: Aged; Anesthesia; Aorta; Bed rest; Bypass; Cardiac and Cardiovascular Systems; Cardiac patients; Cardiac rehabilitation; Cardiac Surgical Procedures; Care and treatment; Clinical trials; Coronary artery; Coronary artery bypass; Correlation; Cross-Sectional Studies; Data recovery; Early Ambulation; Extubation; Female; Heart; Heart surgery; Humans; Immobilization; Intensive care; Intubation; Kardiologi; Male; Medicin och hälsovetenskap; Middle Aged; Observational studies; Patients; Physiotherapy; Postoperative care; Postoperative Care - methods; Rehabilitation; Surgery; Sweden; Thoracic surgery; Time Factors; Valves; Ventilators
• ISSN: 1749-8090; 1749-8090
• DOI: 10.1186/s13019-024-02915-4

Cardiac surgery is associated with a period of postoperative bed rest. Although early mobilization is a vital component of postoperative care, for preventing complications and enhancing physical recovery, there is limited data on routine practices and optimal strategies for early mobilization after cardiac surgery. The aim of the study was to define the timing for the first initiation of out of bed mobilization after cardiac surgery and to describe the type of mobilization performed. In this observational study, the first mobilization out of bed was studied in a subset of adult cardiac surgery patients (n = 290) from five of the eight university hospitals performing cardiothoracic surgery in Sweden. Over a five-week period, patients were evaluated for mobilization routines within the initial 24 h after cardiac surgery. Data on the timing of the first mobilization after the end of surgery, as well as the duration and type of mobilization, were documented. Additionally, information on patient characteristics, anesthesia, and surgery was collected. A total of 277 patients (96%) were mobilized out of bed within the first 24 h, and 39% of these patients were mobilized within 6 h after surgery. The time to first mobilization after the end of surgery was 8.7 ± 5.5 h; median of 7.1 [4.5-13.1] hours, with no significant differences between coronary artery bypass grafting, valve surgery, aortic surgery or other procedures (p = 0.156). First mobilization session lasted 20 ± 41 min with median of 10 [1-11]. Various kinds of first-time mobilization, including sitting on the edge of the bed, standing, and sitting in a chair, were revealed. A moderate association was found between longer intubation time and later first mobilization (ρ = 0.487, p