Early mobilization for mechanically ventilated patients in the intensive care unit: a systematic review and meta-analysis

Yue, Meng; Ma, Zhen; Lei, Mengjie; Cui, Chuyun

doi:10.1515/fon-2018-0039

Cited by 8 publications

(9 citation statements)

References 43 publications

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“…The RCTs were assessed according to the Cochrane 5.1.0 manual. 9 If all risk of bias criteria were met, the study was unlikely to be biased and rated as Grade A; if the criteria were partially met, then the possibility of bias was moderate and the study was rated as Grade B; if the criteria were not met, the study was likely to be biased and rated as Grade C. 10 Cohort studies were evaluated with the Newcastle Ottawa Quality Assessment Scale, and scores of 6-9 were considered good. 11 Disagreement between the 2 researchers was resolved by discussion or by consultation with a third researcher.…”

Section: Study Selection and Methodological Qualitymentioning

confidence: 99%

Safety Assessment Criteria for Early Active Mobilization in Mechanically Ventilated ICU Subjects

et al. 2020

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BACKGROUND: Although studies have confirmed the safety and feasibility of early active mobilization, its implementation status is still unsatisfactory. The most important obstacle is ensuring patient safety. Comprehensively assessing the physical condition of patients considered for mobilization is the basis of safety. However, appropriate guidance is lacking. We performed a systematic review to extract and summarize current safety assessment criteria for the early active mobilization of mechanically ventilated patients in the ICU. METHODS: A systematic literature search was conducted using English and Chinese databases according to the PRISMA checklist and guidelines to identify relevant original studies that evaluated safety assessment variables and specific parameters. RESULTS: A total of 24 medium-and high-quality articles involving a total of 4,842 subjects were included in the analysis. Among these studies, there were 15 randomized controlled trials involving 1,777 subjects (888 in the control groups, 889 in the interventional groups) and 9 cohort studies involving 3,065 subjects (1,240 in the control groups, 1,825 in the exposure groups). There were 5 safety assessment criteria, including cardiovascular, respiratory, neurological, musculoskeletal, and other. Within these were 17 different variables and 48 specific parameters. CONCLUSIONS: The safety assessment criteria should focus on cardiac reserve, respiratory reserve, consciousness, and muscle strength. It is especially important to note whether the parameters are stable because parameter stability can be more representative of a patient's condition than absolute values. We provide a flow diagram for clinical safety assessments; however, some limitations exist, and this assessment requires further validation and optimization.

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Section: Study Selection and Methodological Qualitymentioning

confidence: 99%

Safety Assessment Criteria for Early Active Mobilization in Mechanically Ventilated ICU Subjects

et al. 2020

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“…A mobilização precoce em pessoas internadas em unidade cuidados intensivos, sob ventilação mecânica é segura, viável e benéfica (30)(31)(32) , com diminuição dos dias de ventilação e redução dos dias de internamento na UCI (33 ) e melhoria da função muscular (32,34) , neste sentido, devem realizados esforços sistemáticos para mudar a cultura da UCI de modo a priorizar a mobilização precoce na prática clínica usando uma abordagem interprofissional e várias estratégias, nomeadamente, a implementação de diretrizes de segurança; uso de protocolos de mobilização; formação e educação interprofissional (31,32) .…”

Section: Implicações Para a Prática E Políticas De Saúdeunclassified

Manter a mobilidade articular no doente critico: estudo de caso

Beliz

Bule

Sousa

2020

RPER

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Introdução: A imobilidade no doente crítico é condicionada pela condição de doença ou ainda, pelo efeito de fármacos, mas, em ambos os casos, emerge como um problema na perspetiva da recuperação funcional. A diminuição da massa muscular e da amplitude articular atrasam ou dificultam os processos de recuperação da ventilação espontânea e os autocuidados. Quando o repouso no leito se impõe, os cuidados de enfermagem de reabilitação seguros são um recurso com vista à mitigação dos problemas associados à imobilidade. Objetivo: Avaliar resultados dos cuidados de enfermagem de reabilitação após a aplicação de uma intervenção estruturada de cuidados de mobilização articular passiva em doente crítico. Método: Estudo qualitativo, tipo estudo de caso. É apresentado o caso de uma pessoa adulta em situação crítica á qual foram realizadas oito sessões de mobilização articular por enfermeiro de reabilitação. Avaliada a amplitude articular com recurso a goniometria antes e após a aplicação de um programa de reabilitação. Estudo aprovado em comissão de ética. Resultados: Verificou-se que em 26 dias de internamento em unidade de cuidados intensivos a amplitude articular se manteve nos diferentes segmentos e houve ganhos nos movimentos de supinação do antebraço, extensão da mão esquerda e flexão do joelho direito. A realização de exercícios passivos de mobilização articular não interferiu com a estabilidade de parâmetros fisiológicos ou de adaptação à prótese ventilatória. Conclusões: Os resultados revelam a não ocorrência de diminuição da amplitude articular e são sensíveis aos cuidados de enfermagem de reabilitação, num plano estruturado e regular de mobilizações. Houve ganhos em saúde e a minimização das complicações associadas à imobilidade. Outros estudos devem ser realizados no sentido de parametrizar não só o plano de intervenção bem como a evidência dos resultados obtidos. Descritores: Cuidados Intensivos, Enfermagem de Reabilitação, Acamado, exercícios terapêuticos

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“…5,6 In recent years, therapists have revolutionized the field of fast-track recovery with improvements in PR. 7,8 For patients with NSCLC, there is now a requirement for postoperative PMPR based on research reports.…”

Section: Introductionmentioning

confidence: 99%

Effect of physical manipulation pulmonary rehabilitation on lung cancer patients after thoracoscopic lobectomy

Zhou

Sun

2021

Thoracic Cancer

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Background: To introduce a new postoperative pulmonary rehabilitation program named physical manipulation pulmonary rehabilitation (PMPR) and to explore the effect of perioperative management, including PMPR, on patients with non-small cell lung cancer (NSCLC) after thoracoscopic lobectomy. Methods: A randomized controlled trial was conducted between April and June 2021 at the Department of Thoracic Surgery, Beijing Hospital. Adult patients with NSCLC who had undergone thoracoscopic lobectomy were allocated to the treatment and control groups using a random number table. The treatment group received both conventional pulmonary rehabilitation (CVPR) and 14 days of PMPR after surgery; the control group patients received CVPR only. PMPR included relaxing and exercising the intercostal muscles, thoracic costal joint and abdominal breathing muscles. Pulmonary function tests and the 6-min walk test were conducted preoperatively and 7, 14, 21 and 28 days postoperatively. The postoperative length of hospital stay, chest tube retention time and postoperative pulmonary complications were recorded. The baseline data, pulmonary function parameters and prognosis were compared with t-and chi-square tests between the two groups. Results: A total of 86 patients were enrolled, and 44 patients were allocated to the treatment group. There were no significant differences in the baseline data for age, sex, body mass index, basic disease, surgical plan or preoperative pulmonary function between the two groups (all p > 0.05). The peak expiratory flow of patients in the treatment group was higher than that of those in the control group 21 days after surgery (316 AE 95 vs. 272 AE 103 l/min, respectively, p = 0.043), and forced expiratory volume in the first second on day 28 after surgery was greater than that in the control group (2.1 AE 0.2 vs. 1.9 AE 0.3 L, respectively, p < 0.001). There were no significant differences in forced vital capacity or 6-min walk test scores (both p > 0.05). There were no significant differences in the incidences of pneumonia and atelectasis between the two groups (both p > 0.05). The postoperative length of hospital stay (3.3 AE 1.3 vs. 3.9 AE 1.5 days, p = 0.043) and chest tube retention time (66 AE 30 vs. 81 AE 35 h, p = 0.036) in the treatment group were shorter than those in the control group. Conclusions: We determined that PMPR could improve early lung function in patients with NSCLC after thoracoscopic lobectomy, and that chest tube retention time and length of hospital stay were shortened.

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Early mobilization for mechanically ventilated patients in the intensive care unit: a systematic review and meta-analysis

Cited by 8 publications

References 43 publications

Safety Assessment Criteria for Early Active Mobilization in Mechanically Ventilated ICU Subjects

Safety Assessment Criteria for Early Active Mobilization in Mechanically Ventilated ICU Subjects

Manter a mobilidade articular no doente critico: estudo de caso

Effect of physical manipulation pulmonary rehabilitation on lung cancer patients after thoracoscopic lobectomy

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