Journal ArticleDOI
Safety of Patient Mobilization and Rehabilitation in the Intensive Care Unit. Systematic Review with Meta-Analysis.
Peter Nydahl,Thiti Sricharoenchai,Saurabh Chandra,Firuzan Sari Kundt,Minxuan Huang,M. Fischill,Dale M. Needham +6 more
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TLDR
Patient mobilization and physical rehabilitation in the ICU appears safe, with a low incidence of potential safety events, and only rare events having any consequences for patient management.Abstract:
Background: Early mobilization and rehabilitation of patients in intensive care units (ICUs) may improve physical function, and reduce the duration of delirium, mechanical ventilation, and ICU length of stay. However, safety concerns are an important barrier to widespread implementation.Objectives: To synthesize safety data regarding patient mobilization and rehabilitation in the ICU, including falls, removal of endotracheal tubes, removal or dysfunction of intravascular catheters, removal of other catheters/tubes, cardiac arrest, hemodynamic changes, and desaturation.Data Sources: Systematic literature review, including searches of five databases. Eligible studies evaluated patients who received mobilization-related interventions in the ICU. Exclusion criteria included: (1) case series with fewer than 10 patients; (2) majority of patients under 18 years of age; and (3) data not reported to permit calculation of incidence of safety events.Data Extraction: Number of patients, mobilization/rehabilitation se...read more
Citations
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Journal ArticleDOI
Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU
John W. Devlin,John W. Devlin,Yoanna Skrobik,Céline Gélinas,Dale M. Needham,Arjen J. C. Slooter,Pratik P. Pandharipande,Paula L. Watson,Gerald L. Weinhouse,Mark E. Nunnally,Bram Rochwerg,Michele C. Balas,Mark van den Boogaard,Karen J. Bosma,Karen J. Bosma,Nathaniel E. Brummel,Gerald Chanques,Linda Denehy,Xavier Drouot,Gilles L. Fraser,Jocelyn E. Harris,Aaron M. Joffe,Michelle E. Kho,John P. Kress,Julie A. Lanphere,Sharon McKinley,Karin J. Neufeld,Margaret A. Pisani,Jean François Payen,Brenda T. Pun,Kathleen Puntillo,Richard R. Riker,Bryce R.H. Robinson,Yahya Shehabi,Paul M. Szumita,Chris Winkelman,John Centofanti,Carrie Price,Sina Nikayin,Cheryl Misak,Pamela Flood,Ken Kiedrowski,Waleed Alhazzani +42 more
TL;DR: Substantial agreement was found among a large, interdisciplinary cohort of international experts regarding evidence supporting recommendations, and the remaining literature gaps in the assessment, prevention, and treatment of Pain, Agitation/sedation, Delirium, Immobility (mobilization/rehabilitation), and Sleep (disruption) in critically ill adults.
Journal ArticleDOI
Caring for Critically Ill Patients with the ABCDEF Bundle: Results of the ICU Liberation Collaborative in Over 15,000 Adults.
Brenda T. Pun,Michele C. Balas,Michele C. Balas,Mary Ann Barnes-Daly,Jennifer L. Thompson,J. Matthew Aldrich,Juliana Barr,Juliana Barr,Diane G. Byrum,Shannon S. Carson,John W. Devlin,Heidi J. Engel,Cheryl L. Esbrook,Ken D. Hargett,Lori Harmon,Christina Hielsberg,James C. Jackson,Tamra Kelly,Vishakha K. Kumar,Lawson Millner,Alexandra Morse,Christiane Perme,Patricia Posa,Kathleen Puntillo,William D. Schweickert,Joanna L. Stollings,Alai Tan,Lucy D'Agostino McGowan,E. Wesley Ely +28 more
TL;DR: ABCDEF bundle performance showed significant and clinically meaningful improvements in outcomes including survival, mechanical ventilation use, coma, delirium, restraint-free care, ICU readmissions, and post-ICU discharge disposition.
Journal ArticleDOI
ICU-acquired weakness
TL;DR: Results of studies investigating the impact of early mobilization, neuromuscular electrical stimulation and of pharmacological interventions were inconsistent, with recent systematic reviews/meta-analyses revealing no or only low-quality evidence for benefit.
Journal ArticleDOI
Early mobilization of critically ill patients in the intensive care unit: A systematic review and meta-analysis.
Lan Zhang,Weishu Hu,Zhiyou Cai,Jihong Liu,Jianmei Wu,Yangmin Deng,Keping Yu,Xiaohua Chen,Li Zhu,Jingxi Ma,Yan Qin +10 more
TL;DR: Early mobilization appears to decrease the incidence of ICU-AW, improve the functional capacity, and increase the number of ventilator-free days and the discharged-to-home rate for patients with a critical illness in the ICU setting.
Journal ArticleDOI
Early Mobilization of Patients in Intensive Care: Organization, Communication and Safety Factors that Influence Translation into Clinical Practice.
TL;DR: This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2018 and can be found online at https://www.biomedcentral.com/collections/annualupdate2018.
References
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Journal ArticleDOI
What Are the Barriers to Mobilizing Intensive Care Patients
TL;DR: Critically ill patients can be safely mobilized for much of their ICU stay, and interventions that may allow more patients to mobilize include: changing the site of vascular catheters, careful scheduling of procedures, and improved sedation management.
Journal ArticleDOI
Early physical rehabilitation in intensive care patients with sepsis syndromes: a pilot randomised controlled trial
TL;DR: Implementation of early physical rehabilitation can improve self-reported physical function and induce systemic anti-inflammatory effects in patients with sepsis syndromes.
Journal ArticleDOI
The safety of mobilisation and its effect on haemodynamic and respiratory status of intensive care patients
TL;DR: Although mobilisation resulted in significant increases in heart rate and blood pressure and a non-significant fall in percutaneous oxygen saturation, the ICU patients in this study deemed suitable for mobilisation were able to be safely mobilised.
Journal ArticleDOI
Early Mobilization in Critically Ill Patients: Patients' Mobilization Level Depends on Health Care Provider's Profession
Jaime Garzon-Serrano,Cheryl Ryan,Karen Waak,Ronald E. Hirschberg,Susan Tully,Edward A. Bittner,Daniel Chipman,Ulrich Schmidt,Georgios Kasotakis,John Benjamin,Ross Zafonte,Matthias Eikermann +11 more
TL;DR: To evaluate whether the level of mobilization achieved and the barriers for progressing to the next mobilization level differ between nurses and physical therapists, a database of mobilization levels and barriers is analyzed.
Journal ArticleDOI
Physical declines occurring after hospital discharge in ARDS survivors: a 5-year longitudinal study
Elizabeth R. Pfoh,Elizabeth R. Pfoh,Amy W. Wozniak,Elizabeth Colantuoni,Elizabeth Colantuoni,Victor D. Dinglas,Pedro A. Mendez-Tellez,Carl Shanholtz,Nancy Ciesla,Peter J. Pronovost,Peter J. Pronovost,Dale M. Needham +11 more
TL;DR: Over the follow-up period, the majority of ARDS survivors experienced a physical decline, with older age and pre-ICU comorbidity being important risk factors for this decline.
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