Safety Assessment Criteria for Early Active Mobilization in Mechanically Ventilated ICU Subjects.

BACKGROUND: Although studies have confirmed the safety and feasibility of early active mobilization, its implementation status is still unsatisfactory. The most important obstacle is ensuring patient safety. Comprehensively assessing the physical condition of patients considered for mobilization is...

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Published in:Respiratory Care Vol. 66; no. 2; pp. 307 - 316
Main Authors: Ruiqi Yang, Qiulan Zheng, Dan Zuo, Chuanlai Zhang, Xiuni Gan
Format: algorithm research systematic review tables/charts Journal Article
Published: Mary Ann Liebert, Inc. Feb2021
Online Access:View this record in EBSCOhost
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      dt: Feb2021
      vid: 66
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      pub: Mary Ann Liebert, Inc.
      place: New Rochelle, New York
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        atl: Safety Assessment Criteria for Early Active Mobilization in Mechanically Ventilated ICU Subjects.
      aug:
        au:
          Ruiqi Yang
          Qiulan Zheng
          Dan Zuo
          Chuanlai Zhang
          Xiuni Gan
        affil: The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
      sug:
        subj:
          Patient Safety Evaluation
          Early Ambulation
          Respiration, Artificial
          Intensive Care Units
          Human
          Systematic Review
          PubMed
          Embase
          Cochrane Library
      ab: BACKGROUND: Although studies have confirmed the safety and feasibility of early active mobilization, its implementation status is still unsatisfactory. The most important obstacle is ensuring patient safety. Comprehensively assessing the physical condition of patients considered for mobilization is the basis of safety. However, appropriate guidance is lacking. We performed a systematic review to extract and summarize current safety assessment criteria for the early active mobilization of mechanically ventilated patients in the ICU. METHODS: A systematic literature search was conducted using English and Chinese databases according to the PRISMA checklist and guidelines to identify relevant original studies that evaluated safety assessment variables and specific parameters. RESULTS: A total of 24 medium- and high-quality articles involving a total of 4,842 subjects were included in the analysis. Among these studies, there were 15 randomized controlled trials involving 1,777 subjects (888 in the control groups, 889 in the interventional groups) and 9 cohort studies involving 3,065 subjects (1,240 in the control groups, 1,825 in the exposure groups). There were 5 safety assessment criteria, including cardiovascular, respiratory, neurological, musculoskeletal, and other. Within these were 17 different variables and 48 specific parameters. CONCLUSIONS: The safety assessment criteria should focus on cardiac reserve, respiratory reserve, consciousness, and muscle strength. It is especially important to note whether the parameters are stable because parameter stability can be more representative of a patient's condition than absolute values. We provide a flow diagram for clinical safety assessments; however, some limitations exist, and this assessment requires further validation and optimization.
      pubtype: Academic Journal
      doctype:
        algorithm
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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