Critical Ill Patients
Conditions
Keywords
Early rehabilitation, Physiological response, Critical care
Brief summary
Exploring the physiological and metabolic demands of passive ergometry in the critical ill patient.
Detailed description
This study explores the physiological and metabolic demands of passive ergometry as a step in active rehabilitation and compares two methods of monitoring these changes in critically ill patients.
Interventions
DEVICEMotomed cycle ergometer (MOTOmed letto2 - Reck, Reckstr 1-5, Betzenweiler 88422, Germany).
Sponsors
University Hospital Southampton NHS Foundation Trust
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* already on the Early Mobility Programme (EMP) * cardiovascularly stable (stable vasopressor dose for two hours) * stable heart rate (\<140 bpm) and heart rhythm * presence of a jugular central venous pressure (CVP) line and arterial line.
Exclusion criteria
* prior rapidly deteriorating neuromuscular disease * upper limb problem precluding cycle ergometry * pyrexia (temp \>38 °C) * raised intracranial pressure * poor prognostic outcomes * lack of agreement from clinician * Next of kin/Legal representative (NOK/LR) not understanding English.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Physiological demands of early passive ergometry use in the critically ill patient. | Minute by minute measurements were taken over the 60 minute data collection period. | Haemodynamic measurements collected were arterial systolic and diastolic blood pressure (SBP/DBP mmHg). |
| Physiological demandsof early passive ergometry use in the critically ill patient. | Minute by minute measurements were taken over the 60 minute data collection period. | Respiratory measurements collected were stroke volume (SV m/L). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Comparing two methods of measuring oxygen uptake (VO2 mL/min) and oxygen delivery (DO2 mL/min) during one passive ergometry session in the critically ill patient. | Minute by minute haemodynamic and metabolic measurements were taken over the 60 minute data collection period. Paired venous and arterial blood gas samples were taken every 10 minutes over the 60 minute data collection period. | Oxygen uptake (VO2) was calculated by two methods. 1. Method one calculated VO2 with the value of CO from the LiDCO™ using the modified technique of the Fick equation using paired central mixed venous and arterial blood gas samples: VO2 mL/min = CO x (CaO2 - CvO2) x10. 2. Method two calculated VO2 by the E-COVX metabolic module via the ventilator from the value of fraction of inspired O2 (FiO2), expiratory minute volume (MV), expired concentrations of O2 (FeO2) and CO2 (FeCO2) using the equation: VO2 ml/min= MV (FiO2 -FeO2 - FiO2 (FeCO2))/1-FiO2. |
Outcome results
None listed