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

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, Alisa M. Higgins, Kirsi Maija Kaukonen, Isabel A. Leditschke, Marc R. Nickels, Jennifer Paratz, Shane Patman, Elizabeth H. Skinner, Paul J. YoungJennifer M. Zanni, Linda Denehy, Steven A. Webb

Research output: Contribution to journalArticle

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 (US)
Article number658
JournalCritical Care
Volume18
Issue number6
DOIs
StatePublished - Dec 4 2014

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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    Hodgson, C. L., Stiller, K., Needham, D. M., Tipping, C. J., Harrold, M., Baldwin, C. E., Bradley, S., Berney, S., Caruana, L. R., Elliott, D., Green, M., Haines, K., Higgins, A. M., Kaukonen, K. M., Leditschke, I. A., Nickels, M. R., Paratz, J., Patman, S., Skinner, E. H., ... Webb, S. A. (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