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BioMed Central, Critical Care, 6(18), 2014

DOI: 10.1186/s13054-014-0658-y

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

Journal article published in 2014 by Carol L. Hodgson, Kathy Stiller, Dale M. Needham, Claire J. Tipping, Megan Harrold, Claire E. Baldwin, Scott Bradley, Sue Berney, Lawrence R. Caruana, Doug Elliott, Margot Green, Kimberley Haines ORCID, Alisa M. Higgins, Kirsi-Maija Kaukonen, Isabel Anne Leditschke and other authors.
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

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.