Becovic S1, Fagevik Olsén M2
1Sahlgrenska University Hospital, Occupational Therapy and Physiotherapy, Gothenburg, Sweden, 2Gothenburg University, Sahlgrenska Academy, Dept of Neuroscience and Physiology, Gothenburg, Sweden
Background: Pancreatic surgery is a high risk surgery where the majority of patients develop post-operative atelectasis, however the risk of other cardiovascular complications is low. Mobilisation is known to increase ventilation as well as circulation but studies are missing concerning its effects after major surgery.
Purpose: The purpose of this study is to evaluate the circulatory and respiratory effects of extra early postoperative mobilization after pancreatic surgery.
Methods: A group of patients scheduled to undergo open pancreatic surgery and postoperative care in ICU will be randomized into intervention group (mobilized out of bed the day of surgery and 60 degree head of bed elevation when resting in bed) and control group (mobilized out of bed the day after surgery and 30 degree head of bed elevation according to current practice). Outcome variables include e.g. blood gas, spirometry and feasibility.
Current results are based on the first 50 included patients.
Results: Of the included patients, 25 dropped out because of: 8 no/other surgery performed, 16 logistic reasons, 1 declined. Of the remaining 25 patients 14 were randomised to intervention group and 11 to control group. The groups were comparable at baseline.
All patients in the treatment group were mobilized to sitting on side of bed (SOSOB) the day of surgery. Time spent SOSOB was in median 5 minutes (min 2 and max 20). Ten of the patients also stood up (in median 1 min). The reasons for terminating the mobilisation was nausea (n=4), vertigo (n=2), pain (n=1), low blood pressure (n=4) and confusion (n=1). The treatment group had significantly higher SaO2 than the control group in the evening the day of surgery. They also had a significant higher FEV1 (p=0.034) and a trend to better FVC (p=0.087) the day after surgery.
Conclusion(s): The results from this pilot study indicate that patients undergoing open pancreatic surgery can be mobilized to SOSOB the day of surgery but only for short periods of time and some negative side effects are common. However, the extra early mobilisation has positive effects on oxygen saturation and lung volumes.
Implications: This study is the first to evaluate the effect of extra early mobilization against a non-mobilized group. Through the knowledge of extra early mobilization after pancreatic surgery, post-operative care can be streamlined. Extra early mobilization may shorten time in postoperative care as well as reduce physical reactions and postoperative lung complications.
Keywords: Early mobilization, Carcinoma, Pancreatic Ductal, Pancreatic, Neoplasms
Funding acknowledgements: The study was undertaken by grants from The Local Research and Development Board for Gothenburg and Södra Bohuslän
Purpose: The purpose of this study is to evaluate the circulatory and respiratory effects of extra early postoperative mobilization after pancreatic surgery.
Methods: A group of patients scheduled to undergo open pancreatic surgery and postoperative care in ICU will be randomized into intervention group (mobilized out of bed the day of surgery and 60 degree head of bed elevation when resting in bed) and control group (mobilized out of bed the day after surgery and 30 degree head of bed elevation according to current practice). Outcome variables include e.g. blood gas, spirometry and feasibility.
Current results are based on the first 50 included patients.
Results: Of the included patients, 25 dropped out because of: 8 no/other surgery performed, 16 logistic reasons, 1 declined. Of the remaining 25 patients 14 were randomised to intervention group and 11 to control group. The groups were comparable at baseline.
All patients in the treatment group were mobilized to sitting on side of bed (SOSOB) the day of surgery. Time spent SOSOB was in median 5 minutes (min 2 and max 20). Ten of the patients also stood up (in median 1 min). The reasons for terminating the mobilisation was nausea (n=4), vertigo (n=2), pain (n=1), low blood pressure (n=4) and confusion (n=1). The treatment group had significantly higher SaO2 than the control group in the evening the day of surgery. They also had a significant higher FEV1 (p=0.034) and a trend to better FVC (p=0.087) the day after surgery.
Conclusion(s): The results from this pilot study indicate that patients undergoing open pancreatic surgery can be mobilized to SOSOB the day of surgery but only for short periods of time and some negative side effects are common. However, the extra early mobilisation has positive effects on oxygen saturation and lung volumes.
Implications: This study is the first to evaluate the effect of extra early mobilization against a non-mobilized group. Through the knowledge of extra early mobilization after pancreatic surgery, post-operative care can be streamlined. Extra early mobilization may shorten time in postoperative care as well as reduce physical reactions and postoperative lung complications.
Keywords: Early mobilization, Carcinoma, Pancreatic Ductal, Pancreatic, Neoplasms
Funding acknowledgements: The study was undertaken by grants from The Local Research and Development Board for Gothenburg and Södra Bohuslän
Topic: Cardiorespiratory
Ethics approval required: Yes
Institution: The Regional ethical review board in Gothenburg
Ethics committee: Regional Ethics Committee in Gothenburg
Ethics number: 437-17
All authors, affiliations and abstracts have been published as submitted.
