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Clinical review: Early patient mobilization in the ICU

Early mobilization (EM) of ICU patients is a physiologically logical intervention to attenuate critical illness-associated muscle weakness. However, its long-term value remains controversial. We performed a detailed analytical review of the literature using multiple relevant key terms in order to pr...

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Autores principales: Hodgson, Carol L, Berney, Sue, Harrold, Megan, Saxena, Manoj, Bellomo, Rinaldo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4057255/
https://www.ncbi.nlm.nih.gov/pubmed/23672747
http://dx.doi.org/10.1186/cc11820
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author Hodgson, Carol L
Berney, Sue
Harrold, Megan
Saxena, Manoj
Bellomo, Rinaldo
author_facet Hodgson, Carol L
Berney, Sue
Harrold, Megan
Saxena, Manoj
Bellomo, Rinaldo
author_sort Hodgson, Carol L
collection PubMed
description Early mobilization (EM) of ICU patients is a physiologically logical intervention to attenuate critical illness-associated muscle weakness. However, its long-term value remains controversial. We performed a detailed analytical review of the literature using multiple relevant key terms in order to provide a comprehensive assessment of current knowledge on EM in critically ill patients. We found that the term EM remains undefined and encompasses a range of heterogeneous interventions that have been used alone or in combination. Nonetheless, several studies suggest that different forms of EM may be both safe and feasible in ICU patients, including those receiving mechanical ventilation. Unfortunately, these studies of EM are mostly single center in design, have limited external validity and have highly variable control treatments. In addition, new technology to facilitate EM such as cycle ergometry, transcutaneous electrical muscle stimulation and video therapy are increasingly being used to achieve such EM despite limited evidence of efficacy. We conclude that although preliminary low-level evidence suggests that EM in the ICU is safe, feasible and may yield clinical benefits, EM is also labor-intensive and requires appropriate staffing models and equipment. More research is thus required to identify current standard practice, optimal EM techniques and appropriate outcome measures before EM can be introduced into the routine care of critically ill patients.
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spelling pubmed-40572552014-06-14 Clinical review: Early patient mobilization in the ICU Hodgson, Carol L Berney, Sue Harrold, Megan Saxena, Manoj Bellomo, Rinaldo Crit Care Review Early mobilization (EM) of ICU patients is a physiologically logical intervention to attenuate critical illness-associated muscle weakness. However, its long-term value remains controversial. We performed a detailed analytical review of the literature using multiple relevant key terms in order to provide a comprehensive assessment of current knowledge on EM in critically ill patients. We found that the term EM remains undefined and encompasses a range of heterogeneous interventions that have been used alone or in combination. Nonetheless, several studies suggest that different forms of EM may be both safe and feasible in ICU patients, including those receiving mechanical ventilation. Unfortunately, these studies of EM are mostly single center in design, have limited external validity and have highly variable control treatments. In addition, new technology to facilitate EM such as cycle ergometry, transcutaneous electrical muscle stimulation and video therapy are increasingly being used to achieve such EM despite limited evidence of efficacy. We conclude that although preliminary low-level evidence suggests that EM in the ICU is safe, feasible and may yield clinical benefits, EM is also labor-intensive and requires appropriate staffing models and equipment. More research is thus required to identify current standard practice, optimal EM techniques and appropriate outcome measures before EM can be introduced into the routine care of critically ill patients. BioMed Central 2013 2013-02-28 /pmc/articles/PMC4057255/ /pubmed/23672747 http://dx.doi.org/10.1186/cc11820 Text en Copyright © 2013 BioMed Central Ltd
spellingShingle Review
Hodgson, Carol L
Berney, Sue
Harrold, Megan
Saxena, Manoj
Bellomo, Rinaldo
Clinical review: Early patient mobilization in the ICU
title Clinical review: Early patient mobilization in the ICU
title_full Clinical review: Early patient mobilization in the ICU
title_fullStr Clinical review: Early patient mobilization in the ICU
title_full_unstemmed Clinical review: Early patient mobilization in the ICU
title_short Clinical review: Early patient mobilization in the ICU
title_sort clinical review: early patient mobilization in the icu
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4057255/
https://www.ncbi.nlm.nih.gov/pubmed/23672747
http://dx.doi.org/10.1186/cc11820
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