[Algorithms for early mobilization in intensive care units].
Immobility of patients in intensive care units (ICU) can lead to long-lasting physical and cognitive decline. During the last few years, bundles for rehabilitation were developed, including early mobilization. The German guideline for positioning therapy and mobilization, in general, recommends the development of ICU-specific protocols. The aim of this narrative review is to provide guidance when developing a best practice protocol in one's own field of work. It is recommended to a) implement early mobilization as part of a bundle, including screening and management of patient's awareness, pain, anxiety, stress, delirium and family's presence, b) develop a traffic-light system of specific in- and exclusion criteria in an interprofessional process, c) use checklists to assess risks and preparation of mobilization, d) use the ICU Mobility Scale for targeting and documentation of mobilization, e) use relative safety criteria for hemodynamic and respiratory changes, and Borg Scale for subjective evaluation, f) document and evaluate systematically mobilization levels, barriers, unwanted safety events and other parameters.
Pflegeforschung, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Brunswiker Str. 10, 24105, Kiel, Deutschland. peter.nydahl@uksh.de.
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Nydahl
Akademie der Kreiskliniken Reutlingen, Kreiskliniken Reutlingen GmbH, Reutlingen, Deutschland.
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Dubb
Abteilung Physiotherapie, Universitätsklinikum Marburg, Marburg, Deutschland.
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Filipovic
Anästhesie und Intensivpflege, HELIOS Klinikum Siegburg, Siegburg, Deutschland.
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Hermes
Anästhesie und Intensivpflege, Asklepios Paulinen Klinik Wiesbaden, Wiesbaden, Deutschland.
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Jüttner
Akademie der Kreiskliniken Reutlingen, Kreiskliniken Reutlingen GmbH, Reutlingen, Deutschland.
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Kaltwasser
Zentrale Einrichtung Physiotherapie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland.
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Klarmann
Klinik für Neurologie, Neurophysiologie, Frührehabilitation und Schlafmedizin, Christophsbad Göppingen, Göppingen, Deutschland.
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Mende
Institut für Physikalische Medizin und Rehabilitation, Bereich Innere Medizin/Intensivstation, LKH-Universitätskliniken Innsbruck, Innsbruck, Österreich.
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Nessizius
Universitätsklinik für Physikalische Medizin und Rehabilitation Wien, Wien, Österreich.
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Rottensteiner
D000465:Algorithms; D019985:Benchmarking; D003131:Combined Modality Therapy; D003693:Delirium / Q000534:rehabilitation*; D004282:Documentation / Q000379:methods; D004434:Early Ambulation; D005081:Exercise Therapy; D019983:Guideline Adherence; D006801:Humans; D007362:Intensive Care Units; D026741:Physical Therapy Modalities; D012121:Respiration, Artificial; D018570:Risk Assessment
Delirium; Exercise therapy; Physical therapy modalities; Rehabilitation; Respiration therapy