Tan, Yi Fang;
Pereira, Charlotte;
Shannon, Harriet;
(2022)
A physiotherapy-led early mobilisation protocol for neurosurgical patients with external ventricular drains in intensive care: A service evaluation.
Journal of the Association of Chartered Physiotherapists in Respiratory Care
, 54
(1)
pp. 36-49.
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Abstract
Background: An external ventricular drain (EVD) is used to relieve elevated intracranial pressure in neurosurgical patients, and remains in place for an average of 8 days post-surgery. The presence of an EVD poses a major barrier to early mobilisation due to safety concerns. Eligibility criteria published in EVD mobilisation protocols only consisted of parameters related to the neurological system (Moyer et al., 2017; Young et al., 2019). Parameters pertaining to cardiovascular, respiratory and musculoskeletal systems deemed safe for mobilisation were not stated. Aims: To determine the safety, feasibility and effectiveness of implementing an early mobilisation protocol, which included physiological parameters, in patients with EVDs. Methods: A retrospective service evaluation was conducted in a neurological intensive care unit. Medical records were reviewed for 2 periods from October 2017 to March 2018 (pre-protocol period) and October 2019 to March 2020 (protocol period). Eligible patients for out-of-bed mobilisation were screened and identified by physiotherapists. Results: After protocol implementation, there was a 64.8% increase in the proportion of patients with EVDs mobilised (95% CI, 35.9–82.1%, p <0.0001). Median time from EVD placement to 1st mobilisation decreased from 14 to 3.5 days (p <0.0001). Moreover, the median intensive care and hospital length of stays were significantly reduced from 8 to 3.5 days (p = 0.037) and 38 to 22.5 days (p = 0.030) respectively. No adverse events were recorded in the protocol period. Conclusion: The early mobilisation protocol for patients with EVDs enabled safe, feasible and effective mobilisation. Future prospective, controlled research studies are warranted.
| Type: | Article |
|---|---|
| Title: | A physiotherapy-led early mobilisation protocol for neurosurgical patients with external ventricular drains in intensive care: A service evaluation |
| Open access status: | An open access version is available from UCL Discovery |
| Publisher version: | https://www.acprc.org.uk/data/Journal_Downloads/Jo... |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | External ventricular drain, EVD, early mobilisation, intensive care |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10143181 |
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