The Impact of Early Mobilization Protocol in Patients in the ICU

The Impact of Early Mobilization Protocol in Patients in the ICU of the University Hospital of Santa Maria.

Advances in intensive care and mechanical ventilation (MV) in the past two decades have increased critically ill patient survival. However, some patients require prolonged MV (PMV) and are deconditioned due to respiratory insufficiency caused by underlying disease, adverse effects of medications, and prolonged immobilization. Patients in the intensive care unit (ICU) are often confined to their beds, which results in inactivity, immobility, and severe osteomyoarticular system dysfunction. Our hypothesis is that an early mobilization protocol improves muscle thickness (MT) of the quadriceps femoris, peripheral muscle strength, perceived functional status, gait speed, quality of life, duration of mechanical ventilation, ICU length of stay of the critically ill patient.

The purpose of this study is to evaluate the effects of implementation an early mobilization protocol in critically ill patients in the Intensive Care Unit of the University Hospital of Santa Maria.

Inclusion Criteria:

• Adults (18 years of age or greater)
• Patients in the first 24 hours of mechanical ventilation.
• Patients in the deep sedation will be evaluated by the Richmond Agitation-Sedation Scale (score -4).
• Hemodynamically stable.

Exclusion Criteria:

• Rapidly developing neuromuscular disease
• Evolution of brain death
• Cardiopulmonary arrest
• Elevated intracranial pressure
• Ruptured/leaking aortic aneurysm
• Acute MI before peak troponin has been reached
• Absent lower limb
• Pregnancy
• Unstable fractures contributing to likely immobility
• Hospitalization prior to ICU admission >5 days
• Enrollment in another clinical trial