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Review ArticleSystematic Review

Safety Assessment Criteria for Early Active Mobilization in Mechanically Ventilated ICU Subjects

Ruiqi Yang, Qiulan Zheng, Dan Zuo, Chuanlai Zhang and Xiuni Gan
Respiratory Care February 2021, 66 (2) 307-315; DOI: https://doi.org/10.4187/respcare.07888
Ruiqi Yang
The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Qiulan Zheng
The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Dan Zuo
The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Chuanlai Zhang
The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Xiuni Gan
Department of Nursing, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Abstract

BACKGROUND: Although studies have confirmed the safety and feasibility of early active mobilization, its implementation status is still unsatisfactory. The most important obstacle is ensuring patient safety. Comprehensively assessing the physical condition of patients considered for mobilization is the basis of safety. However, appropriate guidance is lacking. We performed a systematic review to extract and summarize current safety assessment criteria for the early active mobilization of mechanically ventilated patients in the ICU.

METHODS: A systematic literature search was conducted using English and Chinese databases according to the PRISMA checklist and guidelines to identify relevant original studies that evaluated safety assessment variables and specific parameters.

RESULTS: A total of 24 medium- and high-quality articles involving a total of 4,842 subjects were included in the analysis. Among these studies, there were 15 randomized controlled trials involving 1,777 subjects (888 in the control groups, 889 in the interventional groups) and 9 cohort studies involving 3,065 subjects (1,240 in the control groups, 1,825 in the exposure groups). There were 5 safety assessment criteria, including cardiovascular, respiratory, neurological, musculoskeletal, and other. Within these were 17 different variables and 48 specific parameters.

CONCLUSIONS: The safety assessment criteria should focus on cardiac reserve, respiratory reserve, consciousness, and muscle strength. It is especially important to note whether the parameters are stable because parameter stability can be more representative of a patient’s condition than absolute values. We provide a flow diagram for clinical safety assessments; however, some limitations exist, and this assessment requires further validation and optimization.

  • ICU
  • safety assessment
  • active mobilization
  • mechanical ventilation
  • systematic review

Footnotes

  • Correspondence: Xiuni Gan RN, Department of Nursing, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China. E-mail: ganxn{at}163.com
  • The authors have disclosed no conflicts of interest.

  • Supplementary material related to this paper is available at http://www.rcjournal.com.

  • Copyright © 2021 by Daedalus Enterprises
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Respiratory Care: 66 (2)
Respiratory Care
Vol. 66, Issue 2
1 Feb 2021
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Safety Assessment Criteria for Early Active Mobilization in Mechanically Ventilated ICU Subjects
Ruiqi Yang, Qiulan Zheng, Dan Zuo, Chuanlai Zhang, Xiuni Gan
Respiratory Care Feb 2021, 66 (2) 307-315; DOI: 10.4187/respcare.07888

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Safety Assessment Criteria for Early Active Mobilization in Mechanically Ventilated ICU Subjects
Ruiqi Yang, Qiulan Zheng, Dan Zuo, Chuanlai Zhang, Xiuni Gan
Respiratory Care Feb 2021, 66 (2) 307-315; DOI: 10.4187/respcare.07888
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Keywords

  • ICU
  • safety assessment
  • active mobilization
  • mechanical ventilation
  • systematic review

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