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Journal of critical care · Jun 2015
Passive orthostatism (tilt table) in critical patients: Clinicophysiologic evaluation.
- Beatriz Fernandes Toccolini, Erica Fernanda Osaku, Claudia Rejane Lima de Macedo Costa, Sandy Nogueira Teixeira, Nicolle Lamberti Costa, Maria Fernanda Cândia, Marcela Aparecida Leite, Carlos Eduardo de Albuquerque, Amaury Cezar Jorge, and Péricles Almeida Delfino Duarte.
- Intensive Care Unit, Western Parana State University Hospital, Cascavel, PR, Brazil. Electronic address: beatriztoccolini@hotmail.com.
- J Crit Care. 2015 Jun 1; 30 (3): 655.e1-6.
PurposeTo assess the effects of passive orthostatism on various clinicophysiologic parameters of adult intensive care unit (ICU) patients, by daily placement on a tilt table.Materials And MethodsThis prospective cohort study was performed in a general ICU. Twenty-three patients 18 years or older, intubated or tracheostomized, without sedation and under weaning from mechanical ventilation, were analyzed. All variables were evaluated at tilting of 30°, 45°, 60°, 75°, and 90°.ResultsGlasgow Coma Scale increased during tilt in the first and second day, as well as Richmond Agitation-Sedation Scale. No significant differences were detected in the physiological parameters; however, there was a nonsignificant decrease on the mean arterial pressure at angles of 75° and 90°. The maximum inspiratory pressure significantly increased at 60° compared with 30° on day 1 of the intervention. No significant differences were observed for maximum expiratory pressure, rapid shallow breathing index, and the tidal volume.ConclusionA protocol with daily use of a tilt table for ICU patients is safe and improves the level of consciousness and inspiratory maximum pressure, without causing deleterious acute physiological effects.Copyright © 2015 Elsevier Inc. All rights reserved.
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