Mobilization of Intensive Care Cardiac Surgery Patients on Mechanical Circulatory Support

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Abstract

Historically, intensive care cardiac surgery patients remained on bed rest for several days postoperatively to prevent complications and promote rest and healing. Over time, the cardiac surgery discipline has acknowledged the benefits of early mobility, including reduced risk of venous thromboembolism and pulmonary emboli, improved pulmonary toilet, prevention of pneumonia, decreased length of stay, reduced deconditioning, and need for rehabilitation, among others advantages. These benefits have changed clinical practice, with emphasis on early extubation, progressive mobility, and reduced lengths of stay. Early mobility is a staple in postoperative intensive care of cardiac surgery patients. Patient mobility practices include range of motion, dangling at the bedside, and transition to the chair on the operative day, if able. Postoperative day 1 entails transferring from the bed to the chair 2 to 3 times and, if feasible, ambulation in the room and hallway. Patients with pulmonary artery catheters, arterial lines, chest tubes, and mechanical circulatory support devices are included in early progressive mobility to prevent postoperative complications. This article will discuss early progressive mobility in cardiovascular intensive care unit patients, with a focus on specific considerations for patients post–cardiac surgery and those with mechanical circulatory support devices.

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