Complications related to early mobilization in intensive care unit patients with femoral catheters: an integrative literature review

Introduction: Mobility restrictions in patients with femoral catheters are common, and usually relate to concerns about breaking the catheter, dislodgment, line disconnection, or secondary complications like occlusion, thrombosis, vessel injury, or site contamination. This concern can expose the patient to immobilization consequences for a longer period of time, since rehabilitation sessions are often postponed or not performed. Opinions about if it is feasible or not to perform rehabilitation programs in patients with femoral catheters are not the same, although studies state that early mobilization and rehabilitation programs in intensive care unit (ICU) patients contributes to the prevention and minimization of immobilization negative effects. Therefore, this study aims to develop an integrative literature review in order to answer the following research question: “What are the complications related to femoral catheters of ICU patients when early mobilization is performed?” Method: Integrative literature review conducted between February and June of 2019 in CINAHL (via EBSCO), MEDLINE (via PubMed), and SciELO. The keywords were ‘ICU’, ‘early mobilization’, ‘femoral catheter’, and ‘complications’. Two independent reviewers analyzed the relevance of the studies, extracted and synthesized data. Results: Four articles were included in this review. All the articles describe rehabilitation programs, which often include activities like ‘sitting on the side of the bed’, ‘standing at the bedside’, or ‘transfer to a bedside chair’. The studies were focused in similar types of catheters, like arterial, central, venous and dialysis catheters. Only one article describes the occurrence of complication in the inserted catheters, namely infection, obstruction, dislodgment and accidental removal. Complications occurred in 20 of 275 patients. Discussion & Conclusion: Early mobilization does not seem to directly impact the occurrence of complications in inserted femoral catheters of ICU patients. This conclusion is important, since there seems to be some resistance in performing mobility interventions to these patients.