Abstract
IntroductionThe aim of this study was to develop consensus recommendations on safety parameters for mobilizing adult, mechanically ventilated, intensive care unit (ICU) patients.MethodsA systematic literature review was followed by a meeting of 23 multidisciplinary ICU experts to seek consensus regarding the safe mobilization of mechanically ventilated patients.ResultsSafety considerations were summarized in four categories: respiratory, cardiovascular, neurological and other. Consensus was achieved on all criteria for safe mobilization, with the exception being levels of vasoactive agents. Intubation via an endotracheal tube was not a contraindication to early mobilization and a fraction of inspired oxygen less than 0.6 with a percutaneous oxygen saturation more than 90% and a respiratory rate less than 30 breaths/minute were considered safe criteria for in- and out-of-bed mobilization if there were no other contraindications. At an international meeting, 94 multidisciplinary ICU clinicians concurred with the proposed recommendations.ConclusionConsensus recommendations regarding safety criteria for mobilization of adult, mechanically ventilated patients in the ICU have the potential to guide ICU rehabilitation whilst minimizing the risk of adverse events.
Highlights
The aim of this study was to develop consensus recommendations on safety parameters for mobilizing adult, mechanically ventilated, intensive care unit (ICU) patients
Whilst it is important that consideration is given to the potential benefits versus the potential adverse events associated with early progressive mobilization, it is possible that undue concern about adverse events may be resulting in mobilization being withheld where it might otherwise be beneficial
Nature of the safety recommendations The consensus group agreed that the recommendations were aimed at assisting in the assessment of adult, mechanically ventilated ICU patients to determine if and when mobilization could commence
Summary
The aim of this study was to develop consensus recommendations on safety parameters for mobilizing adult, mechanically ventilated, intensive care unit (ICU) patients. In order for early progressive mobilization to be undertaken safely in an ICU setting, with a minimal risk of adverse sequelae, it is essential that patients be carefully assessed prior to any mobilization intervention. Such assessment is facilitated by the availability of objective criteria that indicate that it is reasonable or safe to initiate mobilization [24]. The aim of this study was to develop consensus recommendations on safety criteria that should be considered prior to mobilizing adult, mechanically ventilated, ICU patients
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