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Early Mobilization Of Patients In ICU Improves Outcomes
Now research shows that functional status may be restored earlier to ICU patients by performing daily interruptions in sedation paired with mobilization and exercise, as led by physical and occupational therapists. The study results will be announced on May 17 at the 105th International Conference of the American Thoracic Society in San Diego.
"Weakness and loss of functional independencethe inability to transfer from bed, walk and execute typical daily self-care activities, such as cleaning and dressing oneselfare commonly experienced among patients discharged from the intensive care unit," said William Schweickert, M.D., assistant professor of medicine in the Pulmonary, Allergy, and Critical Care Division at the University of Pennsylvania Medical Center.
"This can result in major disability and protracted rehabilitation and may be accelerated or exacerbated by prolonged periods of immobility, especially among patients who undergo mechanical ventilation and sedation." "Because ICU-acquired weakness is associated with such poor outcomes and potentially exacerbated by deep sedation and immobility, we wanted to see whether mobilization begun in the earliest days of respiratory failure would improve patient function at hospital discharge and reduce delirium," he continued.
Dr. Schweickert and colleagues conducted a randomized trial of 100 patients who were undergoing sedation and mechanical ventilation in the ICU. They compared patients who underwent a protocol of daily mobilization in conjunction with sedative interruption with those who underwent sedative interruption alone and therapy services as ordered by their primary care team. They found that patients who underwent the mobilization protocol were more frequently able to get out of bed, stand and occasionally walk with assistance during mechanical ventilation.
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