Early Mobilization and Rehabilitation in the ICU: Moving Back to the Future.
Despite the historical precedent of mobilizing critically ill patients, bed rest is common practice in ICUs worldwide, especially for mechanically ventilated patients. ICU-acquired weakness is an increasingly recognized problem, with sequelae that may last for months and years following ICU discharge. The combination of critical illness and bed rest results in substantial muscle wasting during an ICU stay. When initiated shortly after the start of mechanical ventilation, mobilization and rehabilitation can play an important role in decreasing the duration of mechanical ventilation and hospital stay and improving patients' return to functional independence. This review summarizes recent evidence supporting the safety, feasibility, and benefits of early mobilization and rehabilitation of mechanically ventilated patients and presents a brief summary of future directions for this field.
Outcomes after Critical Illness and Surgery Group and the Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
Mohamed D
MD
Hashem
Outcomes after Critical Illness and Surgery Group and the Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
Archana
A
Nelliot
Outcomes after Critical Illness and Surgery Group and the Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland. Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, Maryland. dale.needham@jhmi.edu.
Dale M
DM
Needham
D001510:Bed Rest / Q000379:methods / Q000639:trends; D003422:Critical Care / Q000379:methods / Q000639:trends*; D016638:Critical Illness / Q000534:rehabilitation*; D004434:Early Ambulation / Q000639:trends*; D006801:Humans; D007362:Intensive Care Units / Q000639:trends*; D026741:Physical Therapy Modalities / Q000639:trends*; D012121:Respiration, Artificial / Q000379:methods / Q000639:trends
ICU; bed rest; early mobilization; mechanical ventilation; occupational therapy; physical therapy; rehabilitation