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

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• 作者：Carol L Hodgson (1) (2)
  Kathy Stiller (3)
  Dale M Needham (4)
  Claire J Tipping (2)
  Megan Harrold (5)
  Claire E Baldwin (6) (7)
  Scott Bradley (2)
  Sue Berney (8)
  Lawrence R Caruana (9)
  Doug Elliott (10)
  Margot Green (11)
  Kimberley Haines (12) (8)
  Alisa M Higgins (1)
  Kirsi-Maija Kaukonen (1) (13)
  Isabel Anne Leditschke (14) (15)
  Marc R Nickels (16)
  Jennifer Paratz (17) (18)
  Shane Patman (19)
  Elizabeth H Skinner (20) (21)
  Paul J Young (22) (23)
  Jennifer M Zanni (24)
  Linda Denehy (25)
  Steven A Webb (1) (26)
  
  1. Australian and New Zealand Intensive Care Research Centre (ANZIC-RC) ; Department of Epidemiology and Preventive Medicine ; School of Public Health and Preventive Medicine ; Monash University ; 99 Commercial Road ; Melbourne ; Victoria ; 3004 ; Australia
  2. Department of Physiotherapy ; The Alfred ; 55 Commercial Road ; Melbourne ; Victoria ; 3004 ; Australia
  3. Department of Physiotherapy ; Royal Adelaide Hospital ; North Terrace ; Adelaide ; South Australia ; 5000 ; Australia
  4. Outcomes After Critical Illness & Surgery (OACIS) Group ; Division of Pulmonary & Critical Care Medicine ; Department of Physical Medicine & Rehabilitation ; Johns Hopkins Hospital ; 600 N. Wolfe Street ; Meyer 1-130 ; Baltimore ; Maryland ; 21287 ; USA
  5. School of Physiotherapy & Exercise Science ; Curtin University of Technology ; Kent Street ; Bentley ; Western Australia ; 6102 ; Australia
  6. School of Health Sciences ; University of South Australia ; City East Campus ; North Terrace ; Adelaide ; South Australia ; 5001 ; Australia
  7. Physiotherapy Department ; Flinders Medical Centre ; Flinders Drive ; Bedford Park ; South Australia ; 5042 ; Australia
  8. Physiotherapy Department ; Austin Hospital ; 145 Studley Road ; Heidelberg ; Victoria ; 3084 ; Australia
  9. The Prince Charles Hospital ; 627 Rode Road ; Chermside ; Queensland ; 4032 ; Australia
  10. Faculty of Health ; University of Technology ; Sydney (UTS) ; 235 Jones Street ; Broadway ; New South Wales ; 2007 ; Australia
  11. Physiotherapy Department ; Canberra Hospital ; Yamba Drive ; Garran ; Australian Capital Territory ; 2605 ; Australia
  12. Department of Physiotherapy ; St. Vincent鈥檚 Hospital Melbourne ; 41 Victoria Parade ; Fitzroy ; Victoria ; 3065 ; Australia
  13. Department of Anaesthesiology and Intensive Care ; T枚枚l枚 Hospital ; Helsinki University Central Hospital ; Topeliuksenkatu 5 ; Helsinki ; Finland
  14. Intensive Care Unit ; Canberra Hospital ; Yamba Drive ; Garran ; Australian Capital Territory ; 2605 ; Australia
  15. Australian National University Medical School ; The Canberra Hospital ; Hospital Road ; Garran ; Australian Capital Territory ; 2606 ; Australia
  16. Physiotherapy Department ; Princess Alexandra Hospital ; 199 Ipswich Road ; Woolloongabba ; Queensland ; 4102 ; Australia
  17. Burns ; Trauma & Critical Care Research Centre ; School of Medicine ; The University of Queensland ; Department of Intensive Care Medicine ; Royal Brisbane and Women鈥檚 Hospital ; Herston ; Queensland ; 4029 ; Australia
  18. School of Allied Health Sciences ; Griffith University ; Gold Coast Campus ; Parklands Drive ; Southport ; Queensland ; 4215 ; Australia
  19. School of Physiotherapy ; The University of Notre Dame Australia ; Fremantle Campus ; 19 Mouat Street ; Fremantle ; Western Australia ; 6959 ; Australia
  20. Department of Physiotherapy ; Western Health ; Western Hospital ; Gordon Street ; Footscray ; Victoria ; 3011 ; Australia
  21. Department of Physiotherapy ; School of Primary Health Care ; Monash University ; McMahons Road ; Frankston ; Victoria ; 3199 ; Australia
  22. Capital and Coast District Health Board ; Intensive Care Unit ; Wellington Hospital ; Riddiford Street ; Wellington ; 6021 ; New Zealand
  23. Medical Research Institute of New Zealand ; Wellington Hospital ; Riddiford Street ; Wellington ; 6021 ; New Zealand
  24. Department of Physical Medicine and Rehabilitation ; Johns Hopkins Hospital ; 600 N. Wolfe Street ; Meyer 1-130 ; Baltimore ; Maryland ; 21287 ; USA
  25. Department of Physiotherapy ; Melbourne School of Health Sciences ; The University of Melbourne ; Parkville ; Victoria ; 3010 ; Australia
  26. School of Medicine and Pharmacology ; The University of Western Australia ; 35 Stirling Highway ; Crawley ; Perth ; Western Australia ; 6006 ; Australia
  
• 刊名：Critical Care
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：18
• 期：6
• 全文大小：3,102 KB
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• 刊物主题：Intensive / Critical Care Medicine; Emergency Medicine;
• 出版者：BioMed Central
• ISSN：1364-8535

文摘

Introduction The aim of this study was to develop consensus recommendations on safety parameters for mobilizing adult, mechanically ventilated, intensive care unit (ICU) patients. Methods A systematic literature review was 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 30 breaths/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 the ICU have the potential to guide ICU rehabilitation whilst minimizing the risk of adverse events.