Expert consensus and recommendations on safety criteria for active mobilization of mechanically ventilated critically ill adults

Introduction: To develop consensus recommendations on safety parameters for mobilizing adult, mechanically ventilated, intensive care unit (ICU) patients. Methods: A systematic literature review followed by a meeting of 23 multidisciplinary ICU experts to seek consensus regarding the safe mobilizati...

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Bibliographic Details
Main Authors: Hodgson, C., Stiller, Kathy, Needham, D., Tipping, C., Harrold, Megan, Baldwin, C., Bradley, S., Berney, S., Caruana, L., Elliott, D., Green, M., Haines, K., Higgins, A., Kaukonen, K., Leditschke, I., Nickels, M., Paratz, J., Patman, S., Skinner, E., Young, P., Zanni, J., Denehy, L., Webb, S.
Format: Journal Article
Published: Current Science 2014
Online Access:http://hdl.handle.net/20.500.11937/39891
Description
Summary:Introduction: To develop consensus recommendations on safety parameters for mobilizing adult, mechanically ventilated, intensive care unit (ICU) patients. Methods: A systematic literature review followed by a meeting of 23 multidisciplinary ICU experts to seek consensus regarding the safe mobilization of mechanically ventilated patients. Results: Safety considerations were summarized in four categories: respiratory, cardiovascular, neurological and other. Consensus was achieved on all criteria for safe mobilization, with the exception being levels of vasoactive agents. Intubation via an endotracheal tube was not a contraindication to early mobilization and a fraction of inspired oxygen less than 0.6 with a percutaneous oxygen saturation more than 90% and a respiratory rate less than 30breaths/minute were considered safe criteria for in- and out-of-bed mobilization if there were no other contraindications. At an international meeting, 94 multidisciplinary ICU clinicians concurred with the proposed recommendations. Conclusion: Consensus recommendations regarding safety criteria for mobilization of adult, mechanically ventilated patients in ICU have the potential to guide ICU rehabilitation whilst minimizing the risk of adverse events.