Early mobilization for mechanically ventilated patients in the intensive care unit: a systematic review and meta-analysis
Article Category: Original article
Published Online: Dec 31, 2018
Page range: 301 - 310
Received: Aug 11, 2017
Accepted: Mar 26, 2018
DOI: https://doi.org/10.1515/fon-2018-0039
Keywords
© 2018 Meng Yue et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.
Background
Early mobilization (EM) is a regimen that was carried out by physiotherapists in a relatively early stage. It has been investigated by an increasing number of researchers. However, there has not been a meta-analysis concerning whether EM could benefit the clinical outcomes of critically ill patients requiring mechanical ventilation (MV). The present systematic review aims to evaluate the effect of EM compared with immobilization for mechanically ventilated patients.
Methods
A computerized literature search was performed in six databases for related articles from inception to June 2017. We included randomized controlled trials and controlled clinical trials and used the Physiotherapy Evidence Database scale to assess the quality of included studies. Primary outcomes were measures of muscle function, duration of MV, and incidence of mortality. Secondary outcomes were adverse effects and length of stay (LOS) in intensive care unit (ICU) and hospital.
Results
Eight trials were included; of those, only one study without standard EM reported that the intervention was invalid to improve the outcomes. The result of meta-analysis indicated that EM shortened the duration of MV; however, it had no positive effect on mortality and LOS in ICU.
Conclusions
This review suggests that EM improves the muscle function and ventilation duration. Further research highlighting standard intervention and specific groups is needed.