Early Passive Verticalization in Critically Ill Patients

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

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)

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