Mobilisation of intensive care patients receiving blood pressure support medications: an observational study

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Early rehabilitation of intensive care (ICU) patients is essential to reduce the residual burden of ICU-acquired weakness. While various guidelines have been published regarding safety criteria for mobilizing ICU patients (eg Hodgson et al 2014), there is little clarity regarding the safety of mobilizing patients receiving drugs which support blood pressure (vasopressors). At Canberra Hospital ICU, we have a well-established routine practice of mobilizing ICU patients (eg Green et al 2016, Leditschke et al 2012, Green et al 2009), including those receiving vasopressors. Note that ‘mobilisation’ can include standing people in a relatively passive way (eg with tilt table equipment) and / or sitting patients over the edge of the bed etc. Thus we can mobilise even sedated and / or delirious patients if required. There is very little data about the relationship between vasopressor dose and mobility level that is achievable in ICU. We wish to describe our usual practice in detail, including accurate quantification of frequency of mobilisation and corresponding dosage of vasopressors. This information will be useful not just to inform our own future practice, but also to other ICU clinicians around the world who seek more clarity on safety criteria for mobilizing patients in ICU. This study is a simple retrospective audit of our usual practice which will allow us to describe our mobilisation practices across a 3 month period. All the information required for this study is already collected routinely in the Metavision computer program in ICU, thus this study will not pose any additional burden to patients or staff. It is intended that the results of this study would be published in a reputable critical care journal, as well as presented at scientific meetings.

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