Quantifying postoperative mobilisation following oesophagectomy

Area of Science:

• Critical Care Medicine
• Surgical Recovery
• Rehabilitation Science

Background:

• Early mobilisation is crucial for postoperative recovery after complex surgeries like oesophagectomy.
• Evidence guiding early mobilisation protocols in critical care settings remains limited.
• Actual postoperative mobilisation levels following oesophagectomy are not well understood.

Purpose of the Study:

• To quantify postoperative mobilisation levels in patients undergoing oesophagectomy.
• To identify barriers affecting mobility in the postoperative critical care setting.

Main Methods:

• A prospective observational study was conducted in a postoperative critical care setting.
• Thirty participants scheduled for oesophagectomy were enrolled.
• Objective measurement of physical activity using Actigraph GT3X+ and analysis of medical records for influencing factors.

Main Results:

• Participants spent over 96% of their time sedentary during postoperative days 1-5.
• Light intensity activity and daily step count increased significantly from postoperative day 1 to day 5 (p<0.001).
• Haemodynamic instability was the most frequently reported barrier to attempting or limiting mobility.

Conclusions:

• Despite daily physiotherapy, significant challenges hinder postoperative mobilisation after oesophagectomy.
• Haemodynamic instability, potentially linked to thoracic epidurals, is a primary limitation to early mobilisation.
• Collaborative, goal-directed mobilisation involving the multidisciplinary team may help overcome modifiable barriers.