Bed Rest Syndrome

Abstract

Although being bedridden might be an inevitable situation in some clinical conditions, the overlap of geriatric syndromes in aging patients due to frailty could lead to bed rest syndrome. Prolonged bed rest is associated with several time-dependent effects, and the effects of being bedridden have an impact on the whole organism. Bed rest syndrome can affect the cardiovascular, respiratory, urinary, gastrointestinal and/or endocrine systems, as well as the skin, muscles, bones, central and peripheral nervous system; physiopathological mechanisms start very soon after immobilization and can lead to prolonged or irreversible consequences.

The safety and efficacy of early mobilization are still debated, and in this chapter we summarize some aspects highlighted in literature. As specifically recommended also in the acute phase of very critical patients, the essential interventions are repeated postural changes during the day as well as joint mobilization, early sitting and positioning, and respiratory rehabilitation (including facilitation of bronchial drainage).

Furthermore, where mobilization is not applicable, adequate hydration/nutrition is necessary, and dietary intake of essential amino acids should be considered.

When immobilization starts, care should be delivered as soon as possible by a multiprofessional team with skills and expertise in medicine, nursing, and physiotherapy.