Clinical trials of early mobilization of critically ill patients.

Abstract

Intensive care unit-acquired weakness is a common complication of critical illness leading to severe functional impairment in many intensive care unit survivors. Critically ill patients who require mechanical ventilation are routinely immobilized for prolonged time periods. This immobilization is exacerbated by frequent administration of sedative agents. Recently, several investigators have described the feasibility and potential benefits of mobilizing mechanically ventilated intensive care unit patients. Such an intervention requires a multidisciplinary team approach to patient care, involving nursing, physical therapy, occupational therapy, and respiratory therapy practitioners. Recent studies of early mobilization of mechanically ventilated intensive care unit patients have noted this intervention to be safe and associated with improved functional outcomes in this extremely ill patient cohort. Such outcomes include high percentages of patients able to ambulate on intensive care unit and hospital discharge and shortened hospital length of stay. With preliminary studies demonstrating remarkable feasibility and successes, further prospective studies of early mobilization are needed to evaluate this intervention.