Abstract
BackgroundThis systematic review and meta-analysis of randomized clinical trials aimed to investigate the efficacy of early mobilization among critically ill adult patients.MethodsWe searched CENTRAL, MEDLINE, and Igaku-Chuo-Zasshi (a Japanese bibliographic database) databases until April 2019 and included randomized control trials to compare early mobilization started within 1 week of intensive care unit (ICU) admission and earlier-than-usual care with the usual care or mobilization initiated later than the intervention. Two authors independently extracted the data of the included studies and assessed their quality. The primary outcomes were in-hospital mortality, length of ICU/hospital stay, and health-related quality of life (QOL).ResultsAmong 1085 titles/abstracts screened, 11 studies (including 1322 patients) were included in the meta-analysis, which was conducted using the random-effects model. The pooled relative risk for in-hospital mortality comparing early mobilization to usual care (control) was 1.12 (95% CI [confidence interval]: 0.80 to 1.58, I2 = 0%). The pooled mean differences for duration of ICU and hospital stay were -1.54 (95% CI: -3.33 to 0.25, I2 = 90%) and -2.86 (95% CI: -5.51 to -0.21, I2 = 85%), respectively. The pooled mean differences at 6 months post-discharge, as measured by the Short Form 36-Item Health Survey and Euro-QOL EQ-5D, were 4.65 (95% CI: -16.13 to 25.43, I2 = 86%) for physical functioning and 0.29 (95% CI: -11.19 to 11.78, I2 = 66%) for the visual analog scale.ConclusionsOur study indicated no apparent differences between early mobilization and usual care in terms of in-hospital mortality and health-related QOL. Detailed larger studies are warranted to evaluate the impact of early mobilization on in-hospital mortality and health-related QOL in critically ill patients.Trial registrationPROSPERO (identifier CRD42019139265)
Highlights
This systematic review and meta-analysis of randomized clinical trials aimed to investigate the efficacy of early mobilization among critically ill adult patients
With regard to blinding participants and personnel, we evaluated the primary outcome of mortality as “low” risk because it was not likely to be influenced by a lack of blinding
Summary of the main results Our systematic review and meta-analysis indicated that there were no apparent differences between early mobilization and control in terms of in-hospital mortality and health-related quality of life (QOL) (SF-36PF and EuroQol 5 dimension (EQ-5D) visual analog scale (VAS))
Summary
This systematic review and meta-analysis of randomized clinical trials aimed to investigate the efficacy of early mobilization among critically ill adult patients. Mobilization and physiotherapy have been used to prevent post-intensive care syndrome and ICU-acquired weakness (ICU-AW) in critically ill adult patients in the intensive care unit (ICU) [1, 2]. Two systematic reviews (2019) 7:57 on the mortality and health-related QOL of early We compared the extracted data for differences, and dismobilization among critically ill adult patients. Agreements were resolved by discussion among authors
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