Physiological abnormalities and adverse events during physical therapy in the intensive care unit after cardiac surgery: A prospective observational study

After cardiac surgery, physiological abnormalities or adverse events might occur in patients in the intensive care unit (ICU) during physical therapy care. Identifying these events may help improve patient safety and care. To estimate the incidence and the degree of severity of physiological abnorma...

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Published in:	Revista brasileira de fisioterapia (São Carlos (São Paulo, Brazil)) Vol. 25; no. 5; pp. 623 - 631
Main Authors:	Sousa, Mayson Laércio de Araújo, Coimbra, Vera Regina de Moraes, Takei, Mauro Tadashi, Melo, Cyalmê Cristina de Almeida, Feltrim, Maria Ignêz Zaneti, Nozawa, Emilia
Format:	Journal Article
Language:	English
Published:	Elsevier España, S.L.U 01-09-2021 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia
Subjects:	Cardiac surgical procedures Original Research Patient Harm Patient safety Patient Harm Cardiac surgical procedures Patient safety
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Summary:	After cardiac surgery, physiological abnormalities or adverse events might occur in patients in the intensive care unit (ICU) during physical therapy care. Identifying these events may help improve patient safety and care. To estimate the incidence and the degree of severity of physiological abnormalities or adverse events during physical therapy interventions provided in the ICU after cardiac surgery. To explore the relationship between these events and patients’ characteristics and clinical outcomes. Prospective observational study of adult patients in the postoperative period of cardiac surgery admitted to the ICU of a referenced university hospital. Physical therapy interventions were observed by a team trained to evaluate and register the occurrence of physiological abnormalities or adverse events and grading their consequences. We compared baseline characteristics and outcomes of patients with versus without these events. We observed 935 physical therapy interventions in 323 patients, of which 189 (20%, 95% confidence interval: 18, 23%) resulted in physiological abnormalities or adverse events. The highest incidences of these events were observed during endotracheal suctioning (44%), walking (40%), and noninvasive ventilation (37%). Hemodynamic changes were the most frequent events accounting for 74% of all events. Only 2% of interventions resulted in mild harm and 0.2% in moderate harm. The presence of comorbidities was associated (p = 0.03) with the occurrence of these events. Physiological abnormalities or adverse events occurred in 20% of physical therapy interventions in patients in the ICU after cardiac surgery, with 10% of those resulting in negative effects. Only the presence of comorbidities was associated with the occurrence of these events. •The most common adverse events were hemodynamic changes and dizziness/vertigo.•Adverse events were more frequent in mechanically ventilated patients.•Most adverse events required minimal to no additional treatment.•The occurrence of adva adverse events was not associated with worse clinical outcomes.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23
ISSN:	1413-3555 1809-9246
DOI:	10.1016/j.bjpt.2021.04.001