Early mobilisation in the intensive care unit: shifting from navigating risks to a patient-centred approach

People who have overcome critical illness, especially those enduring a prolonged stay in the intensive care unit (ICU) on invasive mechanical ventilation, are at high risk of long-term physical, psychological, and cognitive disabilities. 1 Herridge MS Azoulay É Outcomes after critical illness. N Engl J Med. 2023; 388: 913-924 Crossref PubMed Scopus (71) Google Scholar , 2 Hodgson CL Bailey M Bellomo R et al. Early active mobilization during mechanical ventilation in the ICU. N Engl J Med. 2022; 387: 1747-1758 Crossref PubMed Scopus (95) Google Scholar Mitigating these risks and enhancing an individual's quality of life after ICU discharge are crucial responsibilities of ICU health-care workers and paramount to patients. Rehabilitation activities, including mobilisation to prevent rapid muscle wasting, have been identified as pivotal interventions. However, there are a paucity of data on optimal mobilisation frequency, intensity, type, and time, and it is unclear if specific patient groups have different needs. Association of active mobilisation variables with adverse events and mortality in patients requiring mechanical ventilation in the intensive care unit: a systematic review and meta-analysisImplementation of mobilisation in the ICU was associated with a less than 3% chance of an adverse event occurring and was not found to increase adverse events or mortality overall, providing reassurance for clinicians about the safety of performing this intervention. Subgroup analyses did not clearly identify any specific variable of mobilisation implementation that increased harm. Full-Text PDF