Adverse events during physical therapy on postoperative cardiac surgery receiving noradrenaline

Abstract

Introduction: Cardiac surgery is a highly complex procedure for treating cardiovascular diseases. In the early postoperative period, hemodynamic instability is frequent and noradrenaline is widely used as a rescue measure. During hospitalization, physical therapy in these patients may improve central and peripheral circulation and prevent muscle weakness acquired in the intensive care units, but studies are unclear if it is safe to prescribe exercise to patients undergoing continuous infusion of vasoactive drugs. Objective: To analyze the occurrence of adverse events during physiotherapeutic care in patients undergoing continuous infusion of noradrenaline after cardiac surgery. Methods: This is a retrospective observational study conducted in a cohort of 404 Cardiac Intensive Care Unit (CICU) patients. Data were collected on the occurrence of adverse events during physiotherapeutic care of patients using noradrenaline or not. Additionally, an association between noradrenaline dose, length of stay, and the evolution of mobility progressions was registered. Results: The frequency of adverse events was higher on the first postoperative day (D1), and the recorded adverse events were of low severity, regardless of noradrenaline use. A low but positive correlation was found between noradrenaline dose on D1 and length of stay in the CICU. In addition, a delay in mobilization progression due to the use of moderate and high doses of noradrenaline on D1 was observed. Conclusion: Physical therapy in the postoperative period of cardiac surgery in patients using noradrenaline was safe, with a low incidence of adverse events.