Timing of Mobilization on Delirium in Patients After Cardiac Surgery

Study Overview
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Brief Summary
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Early mobilization is recommended because it is effective in improving symptoms for patients after cardiac surgery. However, the optimal timing of mobilization for postoperative patients is not unclear. How early is early? As early mobilization in the ICU is safe and may reduce healthcare costs, the goal was to assess the effect of early mobilization in the ICU on the incidence and duration of delirium.

Detailed Description
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The prevalence of cardiac diseases is high, as the standard treatment for many heart diseases, a bunch of strategies are performed to improve the outcome of cardiac surgery. Early mobilization is recommended because it is effective in improving symptoms for patients after cardiac surgery. However, the optimal timing of mobilization for postoperative patients is not unclear. How early is early? As early mobilization in the ICU is safe and may reduce healthcare costs, the goal was to assess the effect of early mobilization in the ICU on the incidence and duration of delirium.

Official Title
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The Effect of Timing of Mobilization on Delirium in Patients After Cardiac Surgery: a Pilot Study

Conditions
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Patients After Cardiac Surgery

Intervention / Treatment
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* Other: Early Rehabilitation
* Other: usual treatment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 1. > 18-year-old postoperative cardiac patient admitted to ICU, the time < 24h 2. Patients agree to participate in clinical research and sign informed consent before the start of the study Exclusion Criteria: Patients who meet any of the following criteria are not eligible for inclusion in this study: 1. Pregnant and lactating women 2. There are contraindications to getting out of bed： 2.1 Low cardiac output syndrome (1) Application of IABP or PCPS (percutaneous cardiopulmonary support) (2) High doses of vasoactive drugs (norepinephrine> 0.5ug/kg.min) (3) SBP<=80mmHg (4) Acrocyanosis, wet and cold (5) Metabolic acidosis (6) Urine output less than 0.5ml/kg.h for more than 2 hours 2.2 Heart rate greater than or equal to 120 beats per minute at rest 2.3 Orthostatic hypotension (systolic blood pressure less than 80 mmHg after postural change) 2.4 Presence of arrhythmias leading to a drop in blood pressure (e.g., decreased blood pressure due to new-onset atrial fibrillation) 2.5 Difficulty breathing at rest or respiratory rate greater than 30 breaths per minute 2.6 Postoperative bleeding (200ml in 2-3 hours)

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
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: usual treatment<br> | Other: usual treatment<br>* Patients are not allowed to exercise Early Rehabilitation<br>|
| Experimental: Early mobilization<br>early mobilization in the ICU | Other: Early Rehabilitation<br>* Early Rehabilitation for patients after cardiac surgery<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| duration of delirum | The duration of delirum in hours | 7 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| hospital length of stay | hospital length of stay, approximately 10 days | hospital length of stay, approximately 10 days |