Effect of Early Physical Exercise on Pulmonary Ventilation and Recruitment (EFRA)

Effect of Early Physical Exercise on Pulmonary Ventilation and Recruitment Evaluated With Electric Impedance Tomography.

In the critically patient bed rest and immobilization are some of the responsable of the development of respiratory complications. Early physical exercise is a tool to prevent respiratory complications as lost of respiratory muscle strength, decrease in functional residual capacity and hypoxemia improving oxygenation. New technology as electrical impedance tomography (EIT) are available to visualize changes of regional lung aeration. The aim of this study is to assess the effect of early physical exercise improving alveolar recruitment and pulmonary ventilation in intensive care unit (ICU) patients, evaluated with EIT. The ICU patients included at day of evaluation will be evaluated continuously with EIT in different positions. 1) in the supine position (at 30° of inclination), 2) Sitting in chair 3) Active physical exercise 4) And rest in chair after exercise

Early Physical Exercise, Alveolar Recruitment, Electrical Impedance Tomography, Oxygenation, Ventilation

Patients randomized in this group will do 10 minutes of legs cycloergometer active exercise. Continuously evaluated with electric impedance tomography.

Patients randomized in this group will do 10 minutes of hand cycloergometer active exercise. Continuously evaluated with electric impedance tomography.

Patients randomized in this group will do 10 minutes of active walk in place. Continuously evaluated with electric impedance tomography.

Exercise Bike, Early mobilization, Early physical therapy, Early physical rehabilitation, Early physical training, Early physiotherapy, Very early mobilization, Early exercise, Early activity, Early mobility therapy

Handcycle, Early mobilization, Early physical therapy, Early physical rehabilitation, Early physical training, Early physiotherapy, Very early mobilization, Early exercise, Early activity, Early mobility therapy

Early mobilization, March, Static walk, Early physical therapy, Early physical rehabilitation, Early physical training, Early physiotherapy, Very early mobilization, Early exercise, Early activity, Early mobility therapy

Change in pulmonary electric impedance tomography (EIT) before, during and after single session of exercise.

The change in pulmonary recruitment and ventilation will be evaluated with electric impedance tomography (EIT) in single session of exercise. First measure will be made for five minutes with EIT, before the exercise, then second measure will be made during exercise for ten minutes with EIT and finally last measure will be made after exercise for twenty minutes with EIT. All impedanciometries obtained in the patient in different activities will compare each.

Before exercise will be taken a sample of arterial blood gases for determinate the initial PaO2 of the patient. Twenty minutes after exercise will be taken a new sample of arterial blood gases to establish the difference between PaO2 before exercise and after exercise.

Inclusion Criteria: Patient admitted at the Intensive Care Medical/Surgical Unit of Clinic Saint Luc Days of hospitalization between 1 and 10 Hemodynamically stable Patient or family member sign the informed consent Exclusion Criteria: With risk of evisceration Therapy withdrawal With cardiac devices (Pace Maker) Persistent cough Patches or open wounds in zone of electrodes Presence of high vasopressor medication (noradrenaline > 3 mg/h) PEEP > 15 cm H2 Acute Myocardial Infarction Active bleeding Intracranial pressure > 20 mm Hg or with major instability