McArdle's sign in multiple sclerosis.

Abstract

<b>Background:</b> Early mobilization is believed to improve pulmonary function and prevent postoperative pulmonary complications (PPCs) but adherence is low. The value of allocating resources (e.g. staff time) to increase early mobilization is unknown. This study aimed to estimate the extent to which staff-directed facilitation of early mobilization impact on recovery of pulmonary function after colorectal surgery. We also explored the association of the intervention with 30-day PPCs. <b>Methods:</b> Pre-planned analysis of secondary outcomes of a randomized controlled trial (Fiore Jr et al. Ann Surg 2016 [ahead of print]). Patients undergoing colorectal surgery were randomized 1:1 to usual care (preoperative education) or facilitated mobilization (staff dedicated to assist transfers and walking during hospital stay). Forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and peak cough flow (PCF) were measured preoperatively and at 1, 2, 3 days and 4 weeks after surgery. PPCs were defined according to the European Perioperative Clinical Outcome Taskforce. <b>Results:</b> 99 patients were randomized (57% male, 80% laparoscopic, median age 63 and predicted FEV1 97%). There was no between-group difference in recovery of FVC [adjusted difference in slopes 0.002 L/day (95% CI -0.01 to 0.01)], FEV1 [-0.002 L/s/day (-0.01 to 0.06)] or PCF [-0.003 L/s/day (-0.02 to 0.02)]. 30-day PPCs were also not different between groups [adjusted odd ratio 0.56 (0.18 to 1.71)]. <b>Conclusion:</b> This study does not support the need to allocate resources for enhancing early mobilization to improve pulmonary outcomes after colorectal surgery.