BMC anesthesiology · 2026
Metabolic and hemodynamic responses to early passive range of motion in sedated critically ill adults.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Altunalan Turgay, Küçük Ahmet Oğuzhan, Apaydın Umut, Şahin Ömer Faruk, Pehlivanlar Küçük Mehtap
Аннотация
BACKGROUND: Passive range of motion (PROM) is a common early mobilization technique in intensive care, especially for sedated, mechanically ventilated patients. This study aimed to evaluate the effect of early PROM on oxygen consumption (VO₂) and carbon dioxide production (VCO₂) in mechanically ventilated critically ill adults.
METHODS: A prospective observational cohort study was conducted in the tertiary ICU of a university hospital between May and September 2023. PROM was initiated within 24-48 hours of admission in hemodynamically stable, sedated patients (RASS: -2 to -4). A physiotherapist performed a standardized 10-minute PROM protocol. VO₂ and VCO₂ were measured via indirect calorimetry before, during, and after the intervention. Statistical analyses were conducted using a repeated-measures ANOVA, with the average level before and after the measurement, as well as the peak level of VCO₂ during the intervention. Cardiovascular parameters were also recorded.
RESULTS: Twenty-three patients were included. PROM exercises showed a significant quadratic trend in VCO₂; F = 6.686, p = 0.017 and a borderline quadratic trend in VO₂ (F = 4.320, p = 0.050). Heart rate decreased significantly compared to baseline (P = 0.043). No significant change in blood pressure levels was observed.
CONCLUSION: Early PROM exercises in sedated, mechanically ventilated ICU patients induced a quadratic trend in VCO₂ and VO₂, indicating a temporary and reversible metabolic response. PROM does not cause any hemodynamic instability. It accelerates the elimination of metabolic waste and can be used as part of early rehabilitation protocols.
METHODS: A prospective observational cohort study was conducted in the tertiary ICU of a university hospital between May and September 2023. PROM was initiated within 24-48 hours of admission in hemodynamically stable, sedated patients (RASS: -2 to -4). A physiotherapist performed a standardized 10-minute PROM protocol. VO₂ and VCO₂ were measured via indirect calorimetry before, during, and after the intervention. Statistical analyses were conducted using a repeated-measures ANOVA, with the average level before and after the measurement, as well as the peak level of VCO₂ during the intervention. Cardiovascular parameters were also recorded.
RESULTS: Twenty-three patients were included. PROM exercises showed a significant quadratic trend in VCO₂; F = 6.686, p = 0.017 and a borderline quadratic trend in VO₂ (F = 4.320, p = 0.050). Heart rate decreased significantly compared to baseline (P = 0.043). No significant change in blood pressure levels was observed.
CONCLUSION: Early PROM exercises in sedated, mechanically ventilated ICU patients induced a quadratic trend in VCO₂ and VO₂, indicating a temporary and reversible metabolic response. PROM does not cause any hemodynamic instability. It accelerates the elimination of metabolic waste and can be used as part of early rehabilitation protocols.