Should Early Mobilization Be Routine in Mechanically Ventilated Patients?

Schmidt, Ulrich; Knecht, Lauren; MacIntyre, Neil R.

doi:10.4187/respcare.04566

Cited by 15 publications

(18 citation statements)

References 20 publications

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“…A recent systematic review of quantitative and qualitative studies identified weakness as an important capability-related barrier to mobilization 31 . The low prevalence of mobilization practice and of patients mobilized out of bed observed in our study, regardless of length of ICU stay and duration of MV, may be explained by the difficulty in mobilizing patients when they are in the critical phase of their disease and, subsequently, because they experience the effects of such immobility, creating a cycle of immobility 32 . Therefore, weakness should be a key reason why early mobilization is of great importance in the ICU.…”

Section: Discussionmentioning

confidence: 57%

Early mobilization practices of mechanically ventilated patients: a 1-day point-prevalence study in southern Brazil

Fontela¹,

Lisboa²,

Forgiarini-Júnior³

et al. 2018

Clinics

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OBJECTIVES:To assess early mobilization practices of mechanically ventilated patients in southern Brazilian intensive care units (ICUs) and to identify barriers associated with early mobilization and possible complications.METHODS:A prospective, observational, multicenter, 1-day point-prevalence study was conducted across 11 ICUs and included all mechanically ventilated adult patients. Hospital and ICU characteristics and patients' demographic data, the highest level of mobilization achieved in the 24 hours prior to the survey and related barriers, and complications that occurred during mobilization were collected in the hospital and the ICU.RESULTS:A total of 140 patients were included with a mean age of 57±17 years. The median and interquartile range was 7 (3-17) days for the length of ICU stay to the day of the survey and 7 (3-16) days for the duration of mechanical ventilation (MV). The 8-level mobilization scale was classified into two categories: 126 patients (90%) remained in bed (level 1–3) and 14 (10%) were mobilized out of bed (level 4–8). Among patients with an endotracheal tube, tracheostomy, and noninvasive ventilation, 2%, 23%, and 50% were mobilized out of bed, respectively (p<0.001 for differences among the three groups). Weakness (20%), cardiovascular instability (19%), and sedation (18%) were the most commonly observed barriers to achieving a higher level of mobilization. No complications were reported.CONCLUSIONS:In southern Brazilian ICUs, the prevalence of patient mobilization was low, with only 10% of all mechanically ventilated patients and only 2% of patients with an endotracheal tube mobilized out of bed as part of routine care.

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Section: Discussionmentioning

confidence: 57%

Early mobilization practices of mechanically ventilated patients: a 1-day point-prevalence study in southern Brazil

Fontela¹,

Lisboa²,

Forgiarini-Júnior³

et al. 2018

Clinics

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“…Despite good results in some studies, safety concerns remain a key element for mobilizing patients while receiving mechanical ventilation. 3 Early mobilization does not just mean walking. Other tools used to actively mobilize patients include in-bed cycling, dangling from the bed, standing, and bedside transfers from bed to a chair.…”

Section: Enhancing Early Mobility With a Speaking Valvementioning

confidence: 99%

“…In the absence of early mobilization, patients are further prone to ICU-acquired weakness and functional disability. 3 Fatigue, weakness, and decreased functional status are known to last up to 1 year in ICU survivors. Early mobility is associated with decreased ICU length of stay, decreased hospital length of stay, decreased hospital readmissions, and, importantly, increased ventilator-free days.…”

Section: Enhancing Early Mobility With a Speaking Valvementioning

confidence: 99%

Enhancing Early Mobility With a Speaking Valve

Roberts

2020

Respir Care

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“…30% of stroke survivors are estimated to develop some level of dependence that prevents them to perform basic daily activities [6]. Treatment at Intensive Care Units (ICU) and the period after a critical medical episode are also associated with increased physical and psychological morbidity [7]. When we focus on the patient functional rehabilitation, after patients, hemodynamic and respiratory stabilization, early rehabilitation has been seen as a positive intervention that works as an important treatment and modifies the probability of developing negative effects related to functional and physical morbidity.…”

Section: Introductionmentioning

confidence: 99%

Mobility Deficit – Rehabilitate, An Opportunity for Functionality

et al. 2019

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There are many pathological conditions that cause mobility deficits and that ultimately influence someone's autonomy. To overcome these difficulties implies the patient's involvement and professional action, namely from a rehabilitation nurse, whose target is to capacitate the patient. The person can be capacitated and reach quality of life through organized and systematic rehabilitation programs, which can result in health gains. Aims: to evaluate patients with mobility deficits functional status; to implement a Rehabilitation Nursing intervention plan; to monitor health gains through mobility deficits rehabilitation; Method: Cross-sectional study, action research approximation. Nonprobability sampling, 9 patients admitted at an Intensive Care Unit and at a Stroke Unit who fulfilled the inclusion criteria. The intervention plan included two moments of formal evaluation: the initial (T1) and the final (T2) that relied on specific instruments. Results: improvement and solving of rehabilitation nursing diagnoses, increased balance and better transferring ability. Data suggest that the implementation of an intervention plan decreased the level of dependence. Conclusion: Early intervention and the implementation of a nursing rehabilitation intervention plan results in health gains (direct or indirect), decreases the risk of developing Pressure Ulcers (PU) and the risk of developing a situation of immobility that affects patients' autonomy and quality of life.

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Should Early Mobilization Be Routine in Mechanically Ventilated Patients?

Cited by 15 publications

References 20 publications

Early mobilization practices of mechanically ventilated patients: a 1-day point-prevalence study in southern Brazil

Early mobilization practices of mechanically ventilated patients: a 1-day point-prevalence study in southern Brazil

Enhancing Early Mobility With a Speaking Valve

Mobility Deficit – Rehabilitate, An Opportunity for Functionality

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