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

Carol Hodgson, Kathy Stiller, Dale Needham, Claire Tipping, Megan Harrold, Claire Baldwin, Scott Bradley, Sue Berney, Lawrence Caruana, Doug Elliott, Margot Green, Kimberly Haines, Alisa Higgins, Kirsi-Maija Kaukonen, Isabel Leditschke, Marc Nickels, Jennifer Paratz, Shane Patman, Elizabeth Skinner, Paul YoungJennifer Zanni, Linda Denehy, Steven Webb

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    160 Citations (Scopus)

    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.

    Original languageEnglish
    Article number658
    Number of pages9
    JournalCritical Care
    Volume18
    Issue number6
    DOIs
    Publication statusPublished - 2014

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  • Cite this

    Hodgson, C., Stiller, K., Needham, D., Tipping, C., Harrold, M., Baldwin, C., Bradley, S., Berney, S., Caruana, L., Elliott, D., Green, M., Haines, K., Higgins, A., Kaukonen, K-M., Leditschke, I., Nickels, M., Paratz, J., Patman, S., Skinner, E., ... Webb, S. (2014). Expert consensus and recommendations on safety criteria for active mobilization of mechanically ventilated critically ill adults. Critical Care, 18(6), [658]. https://doi.org/10.1186/s13054-014-0658-y