title: Monitoring of Potential Safety Events and Vital Signs during Active Mobilization of Patients Undergoing Continuous Renal Replacement Therapy in a Medical Intensive Care Unit.
abstract: OBJECTIVE
  This study aims to evaluate potential safety events and vital sign changes during active mobilization physical therapy (PT) in critically ill patients undergoing continuous renal replacement therapy (CRRT).
  
  
  METHODS
  A retrospective review was performed on 29 patients who were treated with CRRT and who underwent 81 PT sessions in a medical intensive care unit at a single referral hospital; 15 patients underwent 33 sessions with passive range of motion (PROM) and 17 patients underwent 48 active mobilization PT sessions. Three patients received both types of PT including 8 PROM and 5 active mobilization PT sessions. The occurrences of safety events and vital sign changes during active mobilization PT sessions were evaluated.
  
  
  RESULTS
  The safety events did not develop during 33 sessions with PROM. However, there were 2 safety events (4.1%) during 48 active mobilization PT sessions including one session with mobilization in the bed and the other in a sitting position on the edge of the bed. These safety events exclusively developed during active mobilization PT sessions, in which concomitant extracorporeal membrane oxygenation (ECMO) support and CRRT were delivered. Regarding vital sign changes during PT sessions, there were no significant differences in systolic blood pressure (BP), diastolic BP, mean arterial pressure, heart rate, respiratory rate, or peripheral oxygen saturation before and after both PROM and active mobilization PT sessions.
  
  
  CONCLUSIONS
  This study showed that active mobilization PT can be performed safely in patients who are being treated with CRRT without a significant hemodynamic change. However, the development of potential safety events in patients with ECMO needs to be monitored carefully.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Hyun
authors.initials: H
authors.lastname: Lee
authors.forename: Young Jun
authors.initials: YJ
authors.lastname: Ko
authors.forename: Jinhee
authors.initials: J
authors.lastname: Jung
authors.forename: Aeng Ja
authors.initials: AJ
authors.lastname: Choi
authors.forename: Gee Young
authors.initials: GY
authors.lastname: Suh
authors.forename: Chi Ryang
authors.initials: CR
authors.lastname: Chung
mesh_terms: D000368:Aged; D016638:Critical Illness / Q000628:therapy; D015199:Extracorporeal Membrane Oxygenation; D006439:Hemodynamics; D006801:Humans; D007362:Intensive Care Units; D008875:Middle Aged; D061214:Patient Safety; D026741:Physical Therapy Modalities; D017582:Renal Replacement Therapy; D012189:Retrospective Studies; D055986:Vital Signs