MEDiscuss • Cardiovascular diseases • Bed Rest in Myocardial Infarction

Hello All,
I am a nursing student so sorry if I am not in the right place.
I need to find some references (the best would be a journal article, not very old!) about "bed rest in MI" or "suspected MI". But any reference would help me to do my essay!
Could someone help me?
Thanks a lot!
Andi

Hi andi,

bed rest in general decreases the need of different body tissues and also in mi if the pt. Lies in semisetting position this will be better as by the effect of gravity blood going to the heart will decrease and then vol.overload on the heart will decrease and this should be done in ccu rather than icu

Hi,

PubMed is a nice place to start.

1. Consequences of bed rest. http://www.ncbi.nlm.nih.gov/pubmed/20046130

Abstract
Bed rest is frequently prescribed for critically ill patients because it is assumed to be beneficial for preventing complications, for conserving scarce metabolic resources, and for providing patient comfort. Furthermore, higher levels of physical activity in critically ill patients have been assumed to be impractical or not feasible. Bed rest has been prescribed in the past for several other clinical conditions including acute flares of rheumatoid arthritis, cavitary tuberculosis, acute myocardial infarction, and acute low back pain. However, randomized, controlled, clinical trials failed to demonstrate beneficial effects of bed rest in most of these conditions. Bed rest can cause several complications that may delay or prevent recovery from critical illnesses including disuse muscle atrophy, joint contractures, thromboembolic disease, and insulin resistance. Recent studies demonstrated the feasibility and safety of physical medicine programs in critically ill patients including those with acute respiratory failure requiring mechanical ventilation. Other physical medicine tools, such as neuromuscular electrical stimulation and passive stretching of muscles, may also reduce some complications of bed rest.

2. Bed rest for acute uncomplicated myocardial infarction. http://www.ncbi.nlm.nih.gov/pubmed/17443530

Abstract
BACKGROUND: Bed rest is prescribed to all patients with acute myocardial infarction (AMI), but to a variable extent. Current guidelines (American College of Cardiology/ American Heart Association) recommend at least 12 hours bed rest in patients with uncomplicated ST-elevation myocardial infarction, however the basis for this recommendation is unclear.

OBJECTIVES:
To compare the effects of short versus longer bed rest in patients with uncomplicated AMI.

SEARCH STRATEGY:
We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 2, 2005), MEDLINE (January 1966 - August 2005), EMBASE (January 1988 - August 2005), PASCAL BioMed (January 1996 - August 2005); PsycINFO (January 1966 - August 2005) and BIOSIS Previews (January 1990 - August 2005).

SELECTION CRITERIA:
Randomised and quasi-randomised controlled trials of short versus longer bed rest in patients with uncomplicated AMI were sought.

DATA COLLECTION AND ANALYSIS:
Study selection was performed independently by at least two investigators according to the predefined inclusion criteria. Data were extracted by two investigators independently and in duplicate. Authors were contacted to obtain missing information.

MAIN RESULTS:
We found 15 trials with 1487 patients assigned to a short period of bed rest (median 6 days) and 1471 patients assigned to longer bed rest (median 13 days). Generally the studies were outdated and appeared to be of moderate to poor methodological reporting quality. There was no evidence that shorter bed rest was more harmful than longer bed rest in terms of all cause mortality (RR=0.85 (95%CI 0.68 to 1.07), cardiac mortality (RR=0.81 (95%CI 0.54 to 1.19), or reinfarction (RR=1.07 (95%CI 0.79 to 1.44)).

AUTHORS' CONCLUSIONS:
Bed rest ranging from 2 to 12 days appears to be as safe as longer periods of bed rest. The quality of most trials is unsatisfactory. Current bed rest recommendations are not supported by the existing evidence as the optimal duration of bed rest is unknown. The lack of adequate trials is surprising, considering the large size of several studies to compare effectiveness of drugs on people with AMI.

3. Complete bed rest prescription in an internal medicine ward: a dangerous treatment? http://www.ncbi.nlm.nih.gov/pubmed/18069405

Abstract
A general knowledge led to the assumption that bed rest is beneficial for most illnesses and bed rest is prescribed in a large number of medical conditions. However, evidence from randomised studies and systematic reviews suggest a potentially harmful effect of bed rest. This review article discusses the utility of bed rest in some frequent medical pathologies such as myocardial infarction, pulmonary embolism, community acquired-pneumonia, and low back pain.