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

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Open access
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.
Date
2014
Type
Journal Article

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Citation
Hodgson, C. and Stiller, K. and Needham, D. and Tipping, C. and Harrold, M. and Baldwin, C. and Bradley, S. et al. 2014. Expert consensus and recommendations on safety criteria for active mobilization of mechanically ventilated critically ill adults. Critical Care. 18 (6): pp. 1-9.
Source Title
Critical Care
DOI
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School
School of Physiotherapy and Exercise Science
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This article is published under the Open Access publishing model and distributed under the terms of the Creative Commons License http://creativecommons.org/licenses/by/4.0/ Please refer to the licence to obtain terms for any further reuse or distribution of this work

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Abstract

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.