Mobilization of Mechanically Ventilated Patients in Switzerland

Alberto Sibilla, Peter Nydahl, Nicola Greco, Giuseppe Mungo, Natalie Ott, Ines Unger, Spencer Rezek, Sarah Gemperle, Dale M. Needham, Sapna R. Kudchadkar

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Growing evidence suggests that early mobilization benefits intensive care unit (ICU) patients. However, national practices and the culture of individual ICUs influence mobilization activities. Materials and Methods: In a 1-day, Swiss point prevalence study conducted in 35 ICUs (representing 45% of all ICUs), the highest level of mobilization for mechanically ventilated patients was characterized using the validated ICU Mobility Scale, along with data collection for potential safety events and mobilization barriers. Results: Among 161 mechanically ventilated patients, a total of 33% (n = 53) had active mobilization, with walking achieved by only 2% (n = 4). More severe organ failure was associated with lower mobilization (respiratory Sequential Organ Failure Assessment score: P =.037, cardiac: P =.008, neurology: P <.001). Barriers to mobilization were reported in 71% (n = 115), with deep sedation significantly higher among patients receiving passive versus active mobilization (14% vs 0%, P =.005). Potential safety events occurred in 20% (n = 33) of patients without significant differences between passive and active mobilization. Availability of physiotherapists and appropriate equipment were not reported barriers. Conclusion: Mobilization during mechanical ventilation occurred infrequently with greater organ failure associated with lower mobilization. Addressing the identified modifiable barriers via structured efforts to achieve multidisciplinary culture change is essential to decrease the common use of bed rest in Swiss ICUs.

Original languageEnglish (US)
Pages (from-to)55-62
Number of pages8
JournalJournal of Intensive Care Medicine
Volume35
Issue number1
DOIs
StatePublished - Jan 1 2020

Keywords

  • critical care
  • early mobilization
  • intensive care unit
  • mechanical ventilation
  • physical therapy
  • rehabilitation

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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