Comparison between a standard and a modified early mobilization protocol on oxidative stress and inflammatory parameters in patients with sepsis

Abstract

Introduction: Oxidative stress is considered a promoter of negative outcomes, including severe myopathy, especially in critical care patients. Early mobilization (EM) is the application of physical activity as early as possible to avoid the deleterious bed rest effects. Objective: To evaluate the effect of EM protocol on oxidative stress and inflammatory parameters in patients with sepsis. Methods: Prospective study conducted in critical patients divided in control group (CG) and intervention group (IG). Lactate, procalcitonin, Medical Research Council (MRC) sum score, inflammatory and oxidative stress parameters were obtained before and after protocol. Statistical comparisons among groups for continuous variables were performed using parametric and non-parametric tests. Results: EM increased MRC sum score and reduced lactate (IG: initial 5.40 ± 3.44, final 2.02 ± 0.92; CG: initial 4.64 ± 4.99, final 1.90 ± 0.90, p > 0.05); procalcitonin (IG: initial 43.30 ± 39.20, final 8.01 ± 8.13; CG: initial 33.10 ± 33.70, final 14.00 ± 14.80, p > 0.05); oxidative stress (protein carbonylation: IG: initial 4.82 ± 1.00, final 3.52 ± 0.82, p < 0.05; CG: initial 3.32 ± 0.86, final 2.54 ± 0.49, p > 0.05; malondialdehyde: IG: initial 5.57 ± 1.77, final 2.72 ± 1.30, p < 0.05; CG: initial 3.84 ± 2.61, final 4.84 ± 2.11, p > 0.05); and inflammation (TNF-α IG: initial 6.14 ± 2.28, final 4.85 ± 1.10, p < 0.05; CG: initial 7.98 ± 3.37, final 7.08 ± 3.33, p > 0.05). Conclusion: It is possible to conclude that the modified early mobilization protocol used in this study was effective to reduce oxidative stress and inflammation in sepsis patients.