Early mobilisation of mechanically ventilated patients in the intensive care units: results of a Saudi-wide national survey

Abstract

<b>Background:</b> Uncertainty surrounds the use of early mobilisation (EM) for mechanically ventilated patients in Saudi ICUs. The adoption and spread of such practice may be influenced by existing practice. <b>Methods:</b> A validated instrument was used to evaluate the ICUs9 features, EM&nbsp;practices for mechanically ventilated patients, and barriers. <b>Results:</b> We received a 65% (133/205 ICUs) response rate, despite 64% of the&nbsp;total respondents had no prior training in EM, the prevalence of EM for mechanically ventilated patients was 47%.&nbsp;Among the included ICUs, 55% reported no protocols, 36% initiated EM between 2-5 days of severe illness, and 35% reported that EM for mechanically ventilated patients was entirely based on physician orders.&nbsp;There was at least one EM coordinator in 47% of the ICUs that used EM.&nbsp;Previous training in&nbsp;EM and years of experience of the&nbsp;ICU in-charge were shown to be significant predictors in promoting EM in ICU mechanically ventilated patients, with odds ratios of 7.6 (3.37–17.26) and 1.07 (1.01–1.14), respectively.&nbsp;Lack of protocols for EM, as well as insufficient personnel and poor training to assist EM, were frequent obstacles (Fig 1). <b>Conclusion:</b> In Saudi Arabia, although only 36% of the ICUs had prior EM training,&nbsp;47% of mechanically ventilated patients received EM. To&nbsp;improve the use of EM for mechanically ventilated patients in Saudi ICUs, a holistic approach should be implemented to address the observed modifiable barriers.