Sympathetic activity and early mobilization in patients in intensive and intermediate care with severe brain injuries: a preliminary prospective randomized study.

Détails

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Etat: Public
Version: Final published version
ID Serval
serval:BIB_3804BA3F3ECA
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Sympathetic activity and early mobilization in patients in intensive and intermediate care with severe brain injuries: a preliminary prospective randomized study.
Périodique
BMC neurology
Auteur(s)
Rocca A., Pignat J.M., Berney L., Jöhr J., Van de Ville D., Daniel R.T., Levivier M., Hirt L., Luft A.R., Grouzmann E., Diserens K.
ISSN
1471-2377 (Electronic)
ISSN-L
1471-2377
Statut éditorial
Publié
Date de publication
13/09/2016
Peer-reviewed
Oui
Volume
16
Pages
169
Langue
anglais
Notes
Publication types: Journal Article ; Randomized Controlled Trial
Publication Status: epublish
Résumé
Patients who experience severe brain injuries are at risk of secondary brain damage, because of delayed vasospasm and edema. Traditionally, many of these patients are kept on prolonged bed rest in order to maintain adequate cerebral blood flow, especially in the case of subarachnoid hemorrhage. On the other hand, prolonged bed rest carries important morbidity. There may be a clinical benefit in early mobilization and our hypothesis is that early gradual mobilization is safe in these patients. The aim of this study was to observe and quantify the changes in sympathetic activity, mainly related to stress, and blood pressure in gradual postural changes by the verticalization robot (Erigo®) and after training by a lower body ergometer (MOTOmed-letto®), after prolonged bed rest of minimum 7 days.
Thirty patients with severe neurological injuries were randomized into 3 groups with different protocols of mobilization: Standard, MOTOmed-letto® or Erigo® protocol. We measured plasma catecholamines, metanephrines and blood pressure before, during and after mobilization.
Blood pressure does not show any significant difference between the 3 groups. The analysis of the catecholamines suggests a significant increase in catecholamine production during Standard mobilization with physiotherapists and with MOTOmed-letto® and no changes with Erigo®.
This preliminary prospective randomized study shows that the mobilization of patients with severe brain injuries by means of Erigo® does not increase the production of catecholamines. It means that Erigo® is a well-tolerated method of mobilization and can be considered a safe system of early mobilization of these patients. Further studies are required to validate our conclusions.
The study was registered in the ISRCTN registry with the trial registration number ISRCTN56402432 . Date of registration: 08.03.2016. Retrospectively registered.

Mots-clé
Adolescent, Adult, Aged, Aged, 80 and over, Blood Pressure/physiology, Brain Injuries/physiopathology, Brain Injuries/rehabilitation, Catecholamines/blood, Early Ambulation, Female, Humans, Male, Middle Aged, Physical Therapy Modalities, Young Adult
Pubmed
Open Access
Oui
Création de la notice
23/09/2016 19:13
Dernière modification de la notice
20/08/2019 14:26
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