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A Descriptive Report of Early Mobilization for Critically Ill Ventilated Patients with Cancer
Amanda Weeks1, Claudine Campbell1, Prabalini Rajendram2
1Memorial Sloan Kettering Cancer Center.
Background:
Early mobilization protocols have been successfully implemented to improve function in critically ill patients; however, no study has focused on the oncology population.
Objectives:
To investigate the feasibility of early mobilization and describe the rehabilitation interventions and discharge outcomes in a cohort of critically ill patients with cancer.
Design:
Retrospective review.
Methods:
A retrospective analysis of patients with cancer who participated in occupational and physical therapy while on mechanical ventilation utilizing an institutional early mobilization protocol from June 2010 - July 2011, was completed. Demographic and clinical variables were abstracted, as well as occupational and physical therapy interventions.
Results:
A cohort of 42 cancer patients on mechanical ventilation in the mixed medical/surgical intensive care unit of a comprehensive cancer center received early mobilization during the study period. The majority of participants demonstrated improved cognitive and functional status from the intensive care unit to hospital discharge. There were no reported adverse events during the occupational and physical therapy sessions. Among the 30 hospital survivors, 53% required continued rehabilitation services in their home environment and 40% were transferred to a rehabilitation facility.
Limitations:
Due to the small sample size, these findings are not generalizable to all critically ill cancer patients. There was no post-acute care follow-up of cognitive and physical functional performance.
Conclusion:
Early mobilization appears feasible in addressing the cognitive and functional needs of oncology patients in the intensive care unit.
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