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Critical Care
Published in: Critical Care 4/2014

Open Access 01-08-2014 | Research

Early mobilization on continuous renal replacement therapy is safe and may improve filter life

Authors: Yi Tian Wang, Terry P Haines, Paul Ritchie, Craig Walker, Teri A Ansell, Danielle T Ryan, Phaik-Sim Lim, Sanjiv Vij, Rebecca Acs, Nigel Fealy, Elizabeth H Skinner

Published in: Critical Care | Issue 4/2014

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Abstract

Introduction

Despite studies demonstrating benefit, patients with femoral vascular catheters placed for continuous renal replacement therapy are frequently restricted from mobilization. No researchers have reported filter pressures during mobilization, and it is unknown whether mobilization is safe or affects filter lifespan. Our objective in this study was to test the safety and feasibility of mobilization in this population.

Methods

A total of 33 patients undergoing continuous renal replacement therapy via femoral, subclavian or internal jugular vascular access catheters at two general medical-surgical intensive care units in Australia were enrolled. Patients underwent one of three levels of mobilization intervention as appropriate: (1) passive bed exercises, (2) sitting on the bed edge or (3) standing and/or marching. Catheter dislodgement, haematoma and bleeding during and following interventions were evaluated. Filter pressure parameters and lifespan (hours), nursing workload and concern were also measured.

Results

No episodes of filter occlusion or failure occurred during any of the interventions. No adverse events were detected. The intervention filters lasted longer than the nonintervention filters (regression coefficient = 13.8 (robust 95% confidence interval (CI) = 5.0 to 22.6), P = 0.003). In sensitivity analyses, we found that filter life was longer in patients who had more position changes (regression coefficient = 2.0 (robust 95% CI = 0.6 to 3.5), P = 0.007). The nursing workloads between the intervention shift and the following shift were similar.

Conclusions

Mobilization during renal replacement therapy via a vascular catheter in patients who are critically ill is safe and may increase filter life. These findings have significant implications for the current mobility restrictions imposed on patients with femoral vascular catheters for renal replacement therapy.

Trial registration

Australian and New Zealand Clinical Trials Registry ACTRN12611000733​976 (registered 13 July 2011)
Appendix
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Metadata
Title
Early mobilization on continuous renal replacement therapy is safe and may improve filter life
Authors
Yi Tian Wang
Terry P Haines
Paul Ritchie
Craig Walker
Teri A Ansell
Danielle T Ryan
Phaik-Sim Lim
Sanjiv Vij
Rebecca Acs
Nigel Fealy
Elizabeth H Skinner
Publication date
01-08-2014
Publisher
BioMed Central
Published in
Critical Care / Issue 4/2014
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc14001

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