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

abstract

  • 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.

authors

  • Hodgson, Carol L
  • Stiller, Kathy
  • Needham, Dale M
  • Tipping, Claire J
  • Harrold, Megan
  • Baldwin, Claire E
  • Bradley, Scott
  • Berney, Sue
  • Caruana, Lawrence R
  • Elliott, Doug
  • Green, Margot
  • Haines, Kimberley
  • Higgins, Alisa M
  • Kaukonen, Kirsi-Maija
  • Leditschke, Isabel Anne
  • Nickels, Marc R
  • Paratz, Jennifer
  • Patman, Shane
  • Skinner, Elizabeth H
  • Young, Paul J
  • Zanni, Jennifer M
  • Denehy, Linda
  • Webb, Steven A

publication date

  • 2014