Mobilization of intensive care unit patients during renal replacement therapy: a survey with physical therapists
DOI:
https://doi.org/10.1590/Keywords:
Physical Therapy Modalities, Early Mobilization, Intensive Care Units; Renal Dialysis, Continuous Renal Replacement TAbstract
Although physical therapy techniques are
widely applied at the intensive care unit (ICU), patients
under renal replacement therapy (RRT) are often excluded
from mobility studies. We aimed to investigate which
are the mobilization interventions performed by physical
therapists in ICU patients during RRT and what is the
perception regarding its safety. This was a survey study with
physical therapists who work at ICUs that have continuous
renal replacement therapy (CRRT) and/or intermittent
hemodialysis (IHD) in the city of São Paulo, Brazil. A
structured questionnaire was sent electronically. Responses
were analyzed separately for CRRT and IHD and compared
with proportion test. A total of 71 forms were received,
and 51 were included. Physical therapists were employed
at public (56.8%) and private hospitals, of secondary
(54.9%) and tertiary levels. Nine physical therapists reported specific protocols for mobilization practice during RRT at the ICU.
Mobilization interventions were performed more frequently during
CRRT than IHD (91% vs. 65%, p=0.005). Passive and active limb
mobilization were the most frequently performed interventions.
21% of respondents reported complications for IHD and 26% for
CRRT, mainly related to the hemodialysis system. Many participants
(66.7% for IHD and 44.1% for CRRT) reported to have never
searched for literature recommendations. Among those who
searched, the findings varied greatly. We concluded that there is
lack of standardization for mobilization interventions during RRT.
Mobilization is more frequently performed during CRRT and the
most applied techniques are passive and active limb mobilization.
Complications reported during the mobilization practice were
mainly related to the hemodialysis system and not frequent
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