Safety and feasibility of femoral catheters during physical rehabilitation in the intensive care unit

Abstract Objective Femoral catheters pose a potential barrier to early rehabilitation in the intensive care unit (ICU) due to concerns, such as catheter removal, local trauma, bleeding, and infection. We prospectively evaluated the feasibility and safety of physical therapy (PT) in ICU patients with...

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Bibliographic Details
Published in:Journal of critical care 2013-08, Vol.28 (4), p.535.e9-535.e15
Main Authors: Damluji, Abdulla, MB, ChB, MPH, Zanni, Jennifer M., PT, DScPT, Mantheiy, Earl, BA, Colantuoni, Elizabeth, PhD, Kho, Michelle E., PT, PhD, Needham, Dale M., MD, PhD
Format: Article
Language:English
Subjects:
Activities of Daily Living
Adults
Aged
Catheterization, Peripheral - adverse effects
Catheters
Catheters, Indwelling
Chi-Square Distribution
Confidence intervals
Critical Care
Early mobilization
Feasibility Studies
Female
Femoral Artery
Femoral Vein
Hemodialysis
Hospitals
Humans
Infections
Intensive care
Intensive Care Units
Intervention
Ischemia
Male
Mechanical ventilation
Medical complications
Medicine
Middle Aged
Mortality
Patient safety
Physical Therapy Modalities
Prospective Studies
Rehabilitation
Statistics, Nonparametric
Therapy
Vascular access device
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Summary:Abstract Objective Femoral catheters pose a potential barrier to early rehabilitation in the intensive care unit (ICU) due to concerns, such as catheter removal, local trauma, bleeding, and infection. We prospectively evaluated the feasibility and safety of physical therapy (PT) in ICU patients with femoral catheters. Design, Setting, and Patients We evaluated consecutive medical ICU patients who received PT with a femoral venous, arterial, or hemodialysis catheter(s) in situ. Measurements and Main Results Of 1074 consecutive patients, 239 (22%) received a femoral catheter (81% venous, 29% arterial, 6% hemodialysis; some patients had > 1 catheter). Of those, 101 (42%) received PT interventions, while the catheter was in situ, for a total of 253 sessions over 210 medical ICU (MICU) days. On these 210 MICU days, the highest daily activity level achieved was 49 (23%) standing or walking, 57 (27%) sitting, 25 (12%) supine cycle ergometry, and 79 (38%) in-bed exercises. During 253 PT sessions, there were no catheter-related adverse events giving a 0% event rate (95% upper confidence limit of 2.1% for venous catheters). Conclusions Physical therapy interventions in MICU patients with in situ femoral catheters appear to be feasible and safe. The presence of a femoral catheter should not automatically restrict ICU patients to bed rest.
ISSN:0883-9441
1557-8615
DOI:10.1016/j.jcrc.2013.01.006