The Safe Early Mobilization on CABG

Aim: This study aimed to evaluate the effect of a Safe Early Mobilization Protocol (SEMP) developed for patients undergoing coronary artery bypass graft (CABG) surgery on patient outcomes. Design: A single-center, parallel-group, randomized controlled trial. Methods: The study was conducted with 60 patients in 2023. The intervention group received a Safe Early Mobilization Protocol including bedside elevation, deep breathing and coughing exercises, sitting upright in bed, sitting on the edge of the bed, standing, ambulation, and sitting in a bedside chair from the day of surgery until the fourth postoperative day. The control group received routine mobilization care. Respiratory parameters, orthostatic hypotension (OH), orthostatic intolerance (OI), mobilization distance, anxiety level, and hospital stay were evaluated.

Inclusion Criteria: Hemodynamic stability, defined as: Resting heart rate \88% Receiving dopamine infusion ≤5 mcg/kg/min at the time of enrollment No auditory, speech, or visual impairments No neurological contraindications (e.g., cerebrovascular accident \[CVA\], ataxia, multiple sclerosis \[MS\]) No orthopedic contraindications that prevent mobilization (e.g., fractures or sequelae) Provided informed consent to participate in the study Age ≥18 years Able to speak Turkish Literate patients Exclusion Criteria: Requirement for intra-aortic balloon pump (IABP) support Postoperative cerebrovascular events High-dose inotropic drug infusion in the early postoperative period: Dopamine ≥10 mcg/kg/min Norepinephrine ≥0.5 mcg/kg/min Concurrent dopamine and norepinephrine infusion Severe arrhythmias preventing mobilization, including: Sinus tachycardia ≥120/min Rapid atrial fibrillation Ventricular tachycardia Ventricular fibrillation Advanced chronic obstructive pulmonary disease (COPD) or bronchiectasis Diagnosed anxiety disorders