Physiological Response and Experience Between Sitting in Bed and Sitting in a Chair in ICU

Study Overview
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Brief Summary
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Background: In the work with early mobilization (EM), in intensive care, several types of EM are used A sitting in bed in semi- Fowler's position, sitting on the edge of the bed, and sitting in a chair. Nowadays, it is often possible to achieve a comfortable sitting in the beds in ICU. However, in a recent study by the same author group one of the findings was the importance to get out of bed. Getting out of bed was associated with decreasing feelings of hopelessness and being less ill. It also encouraged the will to fight for recovery. There are few studies in intensive care that have examined what happens to circulation and oxygenation in various forms of sitting. Studies that examined the patient's own experience of sitting in bed compared to sitting in a chair are missing. The aim is therefore to investigate physiological response and experience in patients in intensive care when sitting in bed or in a chair Method: Repeated measures randomized cross-over study Selection: Patients with respiratory and / or circulatory insufficiency requiring intensive care, Inclusion criteria: Approximately 30 respiratory and circulatory stable patients with emergency admission to intensive care. Aged over 18 years, who understands Swedish. The patient and / or relative are asked after the physician in charge has given medical approval. Recruitment is planned to be done by nurses in charge at the unit. Exclusion criteria: Patients who have undergone planned surgery without complications. Intervention: The participants in the study will be measured in two different positions; sitting in bed and sitting in chair. They are randomized to start either sitting in bed or in a chair and will sit for 20 minutes in each position, at 4 - hour intervals. Data collection, physiological variables: The following physiological variables will be measured: Blood pressure and oxygenation by arterial needle and pulse by ECG. They will be measured before the intervention, at the beginning of the intervention, after ten minutes, at the end of the intervention and ten minutes afterwards Data collection, qualitative variables: Rating of the experience of exertion, pain and satisfaction. Data analysis: Statistical analysis of differences between the two positions. For quantitative variables that are normally distributed, paired t-tests will be used. For qualitative variables and non-normally distributed quantitative variables, Wilcoxon character rank test or Mc Nemar test will be used

Official Title
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Comparison of Physiological Response and Experience Between Sitting in Bed and Sitting in a Chair in Patients in Intensive Care

Conditions
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Intensive Care (ICU), Mobilization

Intervention / Treatment
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* Other: Routine care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: emergency admission to intensive care age >18 years understanding Swedish Exclusion Criteria: Respiratory or circulatory instability where mobilization is contraindicated

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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Routine care vs additional mobilization
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Sitting in bed<br>Sitting in bed with 60 degrees elevated back-rest during 20 minutes | Other: Routine care<br>* Mobilization to chair<br>* Other names: Mobilization in bed;|
| Experimental: Sitting in chair<br>Sitting in chair during 20 minutes | Other: Routine care<br>* Mobilization to chair<br>* Other names: Mobilization in bed;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| PaO2 | Arterial oxygen pressure | Within 8 hours after inclusion | 
| PaCO2 | Arterial carbon dioxide pressure | Within 8 hours after inclusion | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Blood pressure | Systolic and diastolic pressure | Within 8 hours after inclusion | 
| SpO2 | Oxygen saturation | Within 8 hours after inclusion | 
| Perceived pain | Visual analogue scale from 0-100 mm | Within 8 hours after inclusion. | 
| Perceived exertion | Borg RPE scale from 6 to 20 | Within 8 hours after inclusion | 
| Perceived satisfaction | Scale with 11 levels from 0 (no enjoyment) to 10 (maximum enjoyment). | Within 8 hours after inclusion | 
| Staff ratings of pain during mobilization | Visual analogue scale from 0-100 mm | Within 8 hours after inclusion | 
| Staff ratings of exertion during mobilization | Borg RPE scale from 6 to 20 | Within 8 hours after inclusion | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Immobilization, Intensive Care