Kristina Fuest1, Stefan J Schaller. 1. Klinikum rechts der Isar, Klinik für Anästhesiologie und Intensivmedizin, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland. kristina.fuest@mri.tum.de.
Abstract
BACKGROUND: Early mobilization is defined as intervention within the first 72 h after intensive care unit (ICU) admission. According to the current state of relevant studies, evidence on early mobilization in critically ill patients is still inconsistent. This leads to insecurity in caretakers and subsequently to incomplete implementation in German ICUs. OBJECTIVES: What type of intervention is suitable for certain patient groups? Which issues remain unresolved? RESULTS: To obtain best possible outcomes, early mobilization should be initiated during the first 72 h after ICU admission. Implementation of early mobilization improves clinical outcome and should be integrated in a patient-centered bundle (such as ABCDEF). Mechanical ventilation is not a contraindication to intervention. Evidence in neurocritical care as well as functionally dependent patients is still low. Mode of intervention and dosage of early mobilisation remain unclear. CONCLUSION: Early mobilization is safe and feasible, resulting in improved outcomes in surgical and medical ICU patients. Further studies are necessary to evaluate the optimal dosage and duration of intervention, especially in neurocritical care patients.
BACKGROUND: Early mobilization is defined as intervention within the first 72 h after intensive care unit (ICU) admission. According to the current state of relevant studies, evidence on early mobilization in critically illpatients is still inconsistent. This leads to insecurity in caretakers and subsequently to incomplete implementation in German ICUs. OBJECTIVES: What type of intervention is suitable for certain patient groups? Which issues remain unresolved? RESULTS: To obtain best possible outcomes, early mobilization should be initiated during the first 72 h after ICU admission. Implementation of early mobilization improves clinical outcome and should be integrated in a patient-centered bundle (such as ABCDEF). Mechanical ventilation is not a contraindication to intervention. Evidence in neurocritical care as well as functionally dependent patients is still low. Mode of intervention and dosage of early mobilisation remain unclear. CONCLUSION: Early mobilization is safe and feasible, resulting in improved outcomes in surgical and medical ICU patients. Further studies are necessary to evaluate the optimal dosage and duration of intervention, especially in neurocritical carepatients.
Entities:
Keywords:
Critical care; Early mobilization; Muscle strength; Muscle weakness; Physiotherapy
Authors: 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; 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-Francois Payen; Brenda T Pun; Kathleen A Puntillo; Richard R Riker; Bryce R H Robinson; Yahya Shehabi; Paul M Szumita; Chris Winkelman; John E Centofanti; Carrie Price; Sina Nikayin; Cheryl J Misak; Pamela D Flood; Ken Kiedrowski; Waleed Alhazzani Journal: Crit Care Med Date: 2018-09 Impact factor: 7.598
Authors: W Lee Titsworth; Jeannette Hester; Tom Correia; Richard Reed; Peggy Guin; Lennox Archibald; A Joseph Layon; J Mocco Journal: J Neurosurg Date: 2012-03-30 Impact factor: 5.115
Authors: S Jean Hsieh; Olufisayo Otusanya; Hayley B Gershengorn; Aluko A Hope; Christopher Dayton; Daniela Levi; Melba Garcia; David Prince; Michele Mills; Dan Fein; Silvie Colman; Michelle Ng Gong Journal: Crit Care Med Date: 2019-07 Impact factor: 7.598
Authors: William D Schweickert; Mark C Pohlman; Anne S Pohlman; Celerina Nigos; Amy J Pawlik; Cheryl L Esbrook; Linda Spears; Megan Miller; Mietka Franczyk; Deanna Deprizio; Gregory A Schmidt; Amy Bowman; Rhonda Barr; Kathryn E McCallister; Jesse B Hall; John P Kress Journal: Lancet Date: 2009-05-14 Impact factor: 79.321
Authors: Brenda T Pun; Michele C Balas; Mary Ann Barnes-Daly; Jennifer L Thompson; J Matthew Aldrich; Juliana Barr; Diane Byrum; Shannon S Carson; John W Devlin; Heidi J Engel; Cheryl L Esbrook; Ken D Hargett; Lori Harmon; Christina Hielsberg; James C Jackson; Tamra L Kelly; Vishakha Kumar; Lawson Millner; Alexandra Morse; Christiane S Perme; Patricia J Posa; Kathleen A Puntillo; William D Schweickert; Joanna L Stollings; Alai Tan; Lucy D'Agostino McGowan; E Wesley Ely Journal: Crit Care Med Date: 2019-01 Impact factor: 7.598
Authors: S John; R Riessen; C Karagiannidis; U Janssens; H-J Busch; M Kochanek; G Michels; C Hermes; M Buerke; S Kluge; M Baumgärtel; S Braune; F Erbguth; V Fuhrmann; P Lebiedz; K Mayer; U Müller-Werdan; M Oppert; F Sayk; D Sedding; C Willam; K Werdan Journal: Med Klin Intensivmed Notfmed Date: 2021-01-11 Impact factor: 0.840