Effectiveness, Safety, and Barriers to Early Mobilization in the Intensive Care Unit.

Gopala Krishna Alaparthi,Stephen Rajan Samuel,Aishwarya Gatty,Sampath Kumar Amaravadi,Timothy Plackett

doi:10.1155/2020/7840743

Abstract

Purpose Patients admitted to the intensive care unit (ICU) are generally confined to bed leading to limited mobility that may have detrimental effects on different body systems. Early mobilization prevents or reduces these effects and improves outcomes in patients following critical illness. The purpose of this review is to summarize different aspects of early mobilization in intensive care. Methods Electronic databases of PubMed, Google Scholar, ScienceDirect, and Scopus were searched using a combination of keywords. Full-text articles meeting the inclusion criteria were selected. Results Fifty-six studies on various aspects such as the effectiveness of early mobilization in various intensive care units, newer techniques in early mobilization, outcome measures for physical function in the intensive care unit, safety, and practice and barriers to early mobilization were included. Conclusion: Early mobilization is found to have positive effects on various outcomes in patients with or without mechanical ventilation. The newer techniques can be used to facilitate early mobilization. Scoring systems—specific to the ICU—are available and should be used to quantify patients' status at different intervals of time. Early mobilization is not commonly practiced in many countries. Various barriers to early mobilization have been identified, and different strategies can be used to overcome them.

Highlights

Patients with critical illness are patients with a life-threatening disease or trauma. Such patients are at an increased risk of developing serious complications from their condition [1]. ey are admitted to the intensive care unit (ICU) and are usually confined to bed which could negatively affect their mobility [2]
Mechanical ventilation, and sedation in the course of critical illness have been associated with restricted joint mobility, muscle weakness, pressure sores, critical illness neuropathies or ICU-acquired weakness, deep vein thrombosis (DVT), long duration of mechanical ventilation, cognitive impairments, and psychological disturbances [2, 3]
Considering the benefits of early mobilization, this study aims to review the available evidence on various aspects of early mobilization in the intensive care unit

Summary

Introduction

Patients with critical illness are patients with a life-threatening disease or trauma. Such patients are at an increased risk of developing serious complications from their condition [1]. Ey are admitted to the intensive care unit (ICU) and are usually confined to bed which could negatively affect their mobility [2]. Changes noticed within the cardiac system include tachycardia, postural hypotension, decreased peak uptake of oxygen, stroke volume, and cardiac output caused due to fluid loss [4]. Residual problems which include reduced physical function and decreased quality of life are frequently experienced by critical illness survivors [5]

Objectives

Results

Conclusion