Jiani Wang1, Dianxu Ren2, Yue Liu3, Yanling Wang4, Bohan Zhang5, Qian Xiao6. 1. School of Nursing, Capital Medical University, Beijing 100069, China. Electronic address: 823609987@qq.com. 2. School of Nursing, University of Pittsburgh, PA 15261, United States. Electronic address: dir8@pitt.edu. 3. School of Nursing, Capital Medical University, Beijing 100069, China. Electronic address: 767739783@qq.com. 4. School of Nursing, Capital Medical University, Beijing 100069, China. Electronic address: wangyanling_eliza@126.com. 5. School of Nursing, Capital Medical University, Beijing 100069, China. Electronic address: zbh1412@163.com. 6. School of Nursing, Capital Medical University, Beijing 100069, China. Electronic address: juliaqx@ccmu.edu.cn.
Abstract
BACKGROUND: Early mobilization is considered a safe and effective therapeutic strategy for accelerating the rehabilitation of patients admitted to the intensive care unit, with a proven benefit for critically ill patients. OBJECTIVES: To evaluate the effects of early mobilization on the prognosis of critically ill patients through a meta-analysis of data pooled from studies meeting the inclusion criteria. DESIGN: Systematic review and meta-analysis. DATA SOURCE: Electronic databases including PubMed, EMBASE, the Cochrane Library, CINAHL, ProQuest, Web of Science, ProQuest Dissertations and Theses, Chinese BioMedical Literature Service System, WANFANG database, CNKI database, and Clinical Trial Register Platform were systematically searched from inception up to December 31, 2019. REVIEW METHODS: Study eligibility was independently evaluated by two researchers. The title and abstract of the studies were first screened, and full-text articles of the remaining studies were screened for verification. Methodologic quality and risk of bias of the included studies were evaluated, and data were extracted from eligible studies. The meta-analysis was conducted using Review Manager v5.3 software. Key outcomes are presented as pooled risk ratio, weighted mean difference, and the corresponding 95% confidential interval . RESULTS: A total of 39 articles were included in the meta-analysis. The results showed that early mobilization improved ventilator-associated pneumonia patients' Medical Research Council score; reduced the incidence of intensive care unit-acquired weakness and intensive care unit-related complications such as ventilator-associated pneumonia, deep vein thrombosis, and pressure sores; and shortened the duration of mechanical ventilation, length of intensive care unit stay and hospital stay. However, there were no statistically significant differences in handgrip strength, delirium rate, intensive care unit mortality, hospital mortality, and physical function- and mental health-related quality of life at 2-3 months and 6 months post-hospital discharge. CONCLUSIONS: Early mobilization was effective in enhancing the recovery of critically ill patients, but more large-scale, multicenter randomized controlled trials are required to further confirm these findings.
BACKGROUND: Early mobilization is considered a safe and effective therapeutic strategy for accelerating the rehabilitation of patients admitted to the intensive care unit, with a proven benefit for critically illpatients. OBJECTIVES: To evaluate the effects of early mobilization on the prognosis of critically illpatients through a meta-analysis of data pooled from studies meeting the inclusion criteria. DESIGN: Systematic review and meta-analysis. DATA SOURCE: Electronic databases including PubMed, EMBASE, the Cochrane Library, CINAHL, ProQuest, Web of Science, ProQuest Dissertations and Theses, Chinese BioMedical Literature Service System, WANFANG database, CNKI database, and Clinical Trial Register Platform were systematically searched from inception up to December 31, 2019. REVIEW METHODS: Study eligibility was independently evaluated by two researchers. The title and abstract of the studies were first screened, and full-text articles of the remaining studies were screened for verification. Methodologic quality and risk of bias of the included studies were evaluated, and data were extracted from eligible studies. The meta-analysis was conducted using Review Manager v5.3 software. Key outcomes are presented as pooled risk ratio, weighted mean difference, and the corresponding 95% confidential interval . RESULTS: A total of 39 articles were included in the meta-analysis. The results showed that early mobilization improved ventilator-associated pneumoniapatients' Medical Research Council score; reduced the incidence of intensive care unit-acquired weakness and intensive care unit-related complications such as ventilator-associated pneumonia, deep vein thrombosis, and pressure sores; and shortened the duration of mechanical ventilation, length of intensive care unit stay and hospital stay. However, there were no statistically significant differences in handgrip strength, delirium rate, intensive care unit mortality, hospital mortality, and physical function- and mental health-related quality of life at 2-3 months and 6 months post-hospital discharge. CONCLUSIONS: Early mobilization was effective in enhancing the recovery of critically illpatients, but more large-scale, multicenter randomized controlled trials are required to further confirm these findings.
Authors: Sriram Krishnaswamy; Walter Ageno; Yaseen Arabi; Tiziano Barbui; Suzanne Cannegieter; Marc Carrier; Audrey C Cleuren; Peter Collins; Laurence Panicot-Dubois; Jane E Freedman; Kathleen Freson; Philip Hogg; Andra H James; Colin A Kretz; Michelle Lavin; Frank W G Leebeek; Weikai Li; Coen Maas; Kellie Machlus; Michael Makris; Ida Martinelli; Leonid Medved; Marguerite Neerman-Arbez; James S O'Donnell; Jamie O'Sullivan; Madhvi Rajpurkar; Verena Schroeder; Paul Clinton Spiegel; Simon J Stanworth; Laura Green; Anetta Undas Journal: Res Pract Thromb Haemost Date: 2021-07-16