Metabolic and hemodynamic responses to early passive range of motion in sedated critically ill adults


ALTUNALAN T., KÜÇÜK A. O., APAYDIN U., Sahin O. F., PEHLİVANLAR KÜÇÜK M.

BMC ANESTHESIOLOGY, cilt.26, sa.1, 2026 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 26 Sayı: 1
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1186/s12871-025-03565-2
  • Dergi Adı: BMC ANESTHESIOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Directory of Open Access Journals
  • Karadeniz Teknik Üniversitesi Adresli: Evet

Özet

BackgroundPassive range of motion (PROM) is a common early mobilization technique in intensive care, especially for sedated, mechanically ventilated patients. This study aimed to evaluate the effect of early PROM on oxygen consumption (VO2) and carbon dioxide production (VCO2) in mechanically ventilated critically ill adults.MethodsA prospective observational cohort study was conducted in the tertiary ICU of a university hospital between May and September 2023. PROM was initiated within 24-48 hours of admission in hemodynamically stable, sedated patients (RASS: -2 to -4). A physiotherapist performed a standardized 10-minute PROM protocol. VO2 and VCO2 were measured via indirect calorimetry before, during, and after the intervention. Statistical analyses were conducted using a repeated-measures ANOVA, with the average level before and after the measurement, as well as the peak level of VCO2 during the intervention. Cardiovascular parameters were also recorded.ResultsTwenty-three patients were included. PROM exercises showed a significant quadratic trend in VCO2; F = 6.686, p = 0.017 and a borderline quadratic trend in VO2 (F = 4.320, p = 0.050). Heart rate decreased significantly compared to baseline (P = 0.043). No significant change in blood pressure levels was observed.ConclusionEarly PROM exercises in sedated, mechanically ventilated ICU patients induced a quadratic trend in VCO2 and VO2, indicating a temporary and reversible metabolic response. PROM does not cause any hemodynamic instability. It accelerates the elimination of metabolic waste and can be used as part of early rehabilitation protocols.