Early Mobility and Walking for Patients with Femoral Arterial Catheters in Intensive Care Unit: a Case Series

Abstract

ABSTRACT Patients with femoral arterial catheters for hemodynamic monitoring are sometimes placed on bed rest because of the anatomical location and perceived risk of catheter-related complications associated with mobility. This practice subjects these patients to the well known adverse effects of inactivity on functional mobility and functional outcomes. Because of limited evidence to link mobility with femoral artery displacement or damage, this practice may be unwarranted and may add to the treatment burden of the patient in the intensive care unit. The purpose of this study was to explore whether physical therapy-directed mobilization of patients with femoral arterial catheters resulted in adverse events. A retrospective case series was undertaken on patients in a 40-bed cardiovascular and thoracic intensive care unit. The list of potential catheter-related adverse events investigated included bleeding at the femoral arterial catheter site, accidental catheter dislodgement and/or removal, non-functioning catheter after activity event, and acute limb ischemia within 24 hours. The 30 patients identified for the study underwent 47 physical therapy sessions with a total of 156 activity events including sitting on the side of the bed, standing at bedside, transfers to a regular chair or a stretcher chair, and walking. No femoral arterial catheter-related adverse events that could be attributed to participation in physical therapy were documented in either the nursing or physical therapy notes. The data from this single center retrospective case series suggest that early mobility and walking activities do not affect femoral arterial catheters used for hemodynamic monitoring and orders for bed rest may unnecessarily add to symptom burden faced by these patients.