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Mobility therapy and central or peripheral catheter-related adverse events in an ICU in Brazil
Natália Pontes Lima1, Gregório Marques Cardim da Silva1, Marcelo Park1
1School of Medicine, University of São Paulo, São Paulo, Brazil.
Insights
Early mobility therapy in the ICU does not increase the risk of catheter-related adverse events. This study found no significant association between mobility interventions and complications like infection, obstruction, or dislodgement for central venous, hemodialysis, or arterial catheters.
Area of Science:
- Critical Care Medicine
- Physical Therapy
- Patient Safety
Background:
- Critically ill patients in the ICU often require indwelling catheters (central venous, hemodialysis, arterial).
- Concerns exist regarding the safety of early mobility therapy in patients with these devices.
- Understanding potential risks is crucial for optimizing patient care.
Purpose of the Study:
- To investigate the association between mobility therapy and catheter-related adverse events in critically ill patients.
- To analyze the incidence of infection, obstruction, and accidental dislodgement.
- To evaluate safety across different catheter types.
Main Methods:
- Retrospective analysis of medical records from an ICU in Brazil (2009-2011).
- Data collected on patient demographics, catheter types (CVCs, HD, IACs), catheter days, and adverse events.
- Mobility therapy sessions were characterized and correlated with adverse events.
Main Results:
- Mobility therapy was provided in 1,268 sessions to 275 patients with catheters.
- Catheter-related adverse events (infection, obstruction, dislodgement) occurred in 20 patients.
- No significant association was found between mobility therapy and any catheter-related adverse event for CVCs, HD catheters, or IACs.
Conclusions:
- In critically ill patients, mobility therapy can be safely implemented without increasing the risk of catheter-related adverse events.
- Findings support the integration of early mobility protocols in ICU settings.
- This suggests mobility therapy does not negatively impact the safety of central venous, hemodialysis, or arterial catheters.
Objective:
To determine whether mobility therapy is associated with central or peripheral catheter-related adverse events in critically ill patients in an ICU in Brazil.
Methods:
A retrospective analysis of the daily medical records of patients admitted to the Clinical Emergency ICU of the University of São Paulo School of Medicine Hospital das Clínicas Central Institute between December of 2009 and April of 2011. In addition to the demographic and clinical characteristics of the patients, we collected data related to central venous catheters (CVCs), hemodialysis (HD) catheters and indwelling arterial catheters (IACs): insertion site; number of catheter days; and types of adverse events. We also characterized the mobility therapy provided.
Results:
Among the 275 patients evaluated, CVCs were used in 49%, HD catheters were used in 26%, and IACs were used in 29%. A total of 1,268 mobility therapy sessions were provided to patients while they had a catheter in place. Catheter-related adverse events occurred in 20 patients (a total of 22 adverse events): 32%, infection; 32%, obstruction; and 32%, accidental dislodgement. We found that mobility therapy was not significantly associated with any catheter-related adverse event, regardless of the type of catheter employed: CVC-OR = 0.8; 95% CI: 0.7-1.0; p = 0.14; HD catheter-OR = 1.04; 95% CI: 0.89-1.21; p = 0.56; or IAC-OR = 1.74; 95% CI: 0.94-3.23; p = 0.07.
Conclusions:
In critically ill patients, mobility therapy is not associated with the incidence of adverse events involving CVCs, HD catheters, or IACs.
