Master of Science
McIntyre, Christopher W
Sepsis is a life-threatening dysregulation of host response to an infectious insult, which often leads to multi-organ failure. Sepsis survivors suffer from post-intensive care syndrome in part due to their prolonged bed rest and lack of mobility. Although early mobilization has been championed as a mechanism to counter the adverse effects associated with ICU immobility, due to sedation and mechanical ventilation, active early mobilization is not often administered in septic patients due to worries of hemodynamic instability and potential for inducing adverse events. Passive exercise is a mobilization modality that circumvents the need for patients to be conscious and participatory in their mobilization sessions, and thus allows for mobilization of critically ill patients during the acute stages of their ICU stay.
This thesis addresses the safety and feasibility of a graded passive mobilization procedure in septic patients to better understand the effects that passive cycling intensity has on patient hemodynamic status, along with organ perfusion status in key organ systems that are at risk of organ dysfunction as a result of the systemic effects of sepsis.
Summary for Lay Audience
Sepsis is a life-threatening syndrome that often results in organ dysfunction and failure. Even following successful stabilization following an initial septic event, sepsis survivors often suffer long-lasting injuries due to prolonged physiologic changes from both the septic event and from their stay in the critical care unit. Early mobilization has been used as a method to reduce immobility in intensive care units (ICU) and has been a deemed safe and feasible mechanism in improving patient outcomes following ICU stay. However, this early mobilization is often active and requires patient alertness and participation, which is not feasible for septic patients that are sedated and unconscious in the early stages of their ICU stay. Passive mobilization is a method of mobilizing patients and reducing immobility even when they are unconscious and unable to participate in physical exercise and is used to bridge the early phases of ICU stay with transition into early active exercise. However, little is known regarding the appropriate amount of passive exercise to administer these sedated, critically ill patients. Thus, this thesis aims to elucidate the impact of passive cycling intensity on a variety of patient safety parameters during early passive exercise.
Chen, Jennifer, "Impact of Graded Passive Cycling on Hemodynamics, Cerebral Blood Flow, and Heart Function in Healthy Adults and Septic ICU Patients" (2020). Electronic Thesis and Dissertation Repository. 7464.
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Available for download on Saturday, October 09, 2021