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In-bed cycling in the ICU; patient safety and recollections with motivational effects

Journal article
Authors Mona Ringdal
Margareta Warrén Stomberg
K. Egnell
Elisabet Wennberg
R. Zätterman
Christian Rylander
Published in Acta Anaesthesiologica Scandinavica
Volume 62
Issue 5
Pages 658-665
ISSN 0001-5172
Publication year 2018
Published at Institute of Clinical Sciences, Department of Anesthesiology and Intensive care
Institute of Health and Care Sciences
Pages 658-665
Language en
Links https://doi.org/10.1111/aas.13070
Keywords adult, aged, Article, artificial ventilation, clinical article, critical illness, cycling, delusion, dyspnea, female, human, in bed cycling, intensive care unit, interview, male, middle aged, mobilization, patient safety, physical activity, priority journal, qualitative analysis, rigidity, weakness
Subject categories Intensive care

Abstract

Background: In-bed cycling (IBC) is gaining interest for implementation in intensive care units. Our main objective was to explore patient recollections and experiences of early mobilization, including IBC. Secondly, we aimed to examine if IBC was safe and feasible. Methods: Eleven participants were interviewed about their experiences during their critical illnesses and active mobilization in the intensive care unit. The interviews were analyzed thematically. Six participants were also monitored for physiological reactions and adverse events during IBC while mechanically ventilated. Results: From the interviews, one main theme with three subthemes was identified. The main theme was: Early mobilization gave a direction toward normalization. The three subthemes were: (1) IBC gave a feeling of control over recovery early on during the critical illness (2) Early mobilization, including IBC, with continuous support from health care professionals gave a feeling of safety and hope for recovery for the patient; and (3) Unpleasant experiences and disorientation were felt during the critical illness and IBC. Furthermore, IBC did not induce large physiological changes or major adverse events in the participants who were monitored for feasibility and safety. Conclusions: Patient interviews indicated that the patients’ participation in early mobilization with emphasis on IBC motivated them to be active in their recovery to regain a good level of health after their earlier critical illness during their intensive care stay. IBC was, in this small study, safe and feasible in the two participating intensive care units.

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