Early Passive Verticalization in Critically Ill Patients

Study Overview
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Brief Summary
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In the critically patient bed rest and inmovilization are some of the responsable of the development of respiratory complications. Early physical exercise is a tool to prevent respiratory complications as lost of respiratory muscle strength, decrease in functional residual capacity and hypoxemia improving oxygenation. In some cases critically ill conditions implies use of pharmacological sedation. That condition limit the active physical exercise. However, some technicals aids as Tilt table allows execution of passive early movilization. The aim of this study is to assess the effect of early passive verticalization assisted by tilt table on alveolar recruitment and pulmonary ventilation in intensive care unit (ICU) patients, evaluated with electrical impedance tomography (EIT) ICU patients included at day of evaluation will be evaluated consecutively with EIT in three stages; 1) in the supine position (at 30° of inclination), 2) verticalized in tilt table (at 60º of inclination) 3) in the supine position (at 30° of inclination)

Official Title
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Effect of Early Passive Verticalization in Pulmonary Recruitment Evaluated With Electric Impedance Tomography

Conditions
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Critical Illness

Intervention / Treatment
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* Other: Rest in bed
* Other: Passive verticalization
* Other: Rest in bed


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient admitted at the Intensive Care Medical/Sirurgical Unite of Clinic Saint Luc Days of hospitalization between 1 and 10 Hemodynamically stable Patient or family member sign the informed consent Sedated patients Exclusion Criteria: With risk of evisceration Therapy withdrawal With cardiac devices (Pace Maker) Persistent cough Patches or open wounds in zone of electrodes Presence of high vasopressor medication (noradrenaline > 3 mg/h) PEEP > 15 cm H2 Acute Myocardial Infarction Active bleeding Intracranial pressure > 20 mm Hg or with major inestability

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 1) Rest in bed<br>First evaluation of EIT with patient in bed at 30º of head inclination during 5 minutes. | Other: Rest in bed<br> <br> * Other names: Basal position;|
| Experimental: 2) Passive Verticalization<br>Second evaluation of EIT with patient in tilt table at 60º of verticalization during 10 minutes. | Other: Passive verticalization<br> <br> * Other names: Early physiotherapy;|
| Experimental: 3) Rest in bed<br>Last evaluation of EIT with patient in bed at 30º of head inclination during 20 minutes. | Other: Rest in bed<br> <br> * Other names: Basal position;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in pulmonary electric impedance tomography (EIT) before, during and after single session of early passive verticalization | The change in pulmonary recruitment will be evaluated with electrical impedance tomography (EIT) in single session of early passive verticalization. First measure will be made for five minutes with EIT, in bed; second measure will be made during passive verticalization for ten minutes with EIT and last measure will be made after verticalization for twenty minutes with EIT. All impedanciometries obtained in the patient in different activities will compare each. | Meassure of EIT during 10 minutes of early passive verticalization and will compared with baseline EIT | 
| Change in PaO2 before, during and after single session of early passive verticalization | Before passive verticalization will be taken a sample of arterial blood gases for determinate the initial PaO2 of the patient. Twenty minutes after passive verticalization will be taken a new sample of arterial blood gases to establish the diference between PaO2 before verticalization and after verticalization | Meassure of PaO2 after 20 minutes of passive verticalization and will compared with baseline PaO2 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Early Physical Exercise, Early Passive Exercise, Alveolar Recruitment, Electrical Impedance Tomography, Oxygenation, Ventilation