Early mobilisation in patients with shock and receiving vasoactive drugs in the intensive care unit: A systematic review and meta-analysis of observational studies.

Abstract

Objective: The aim of the study was to assess the feasibility and safety of early mobilisation in patients with shock requiring vasoactive drugs in the intensive care unit (ICU).

Design: Systematic review and meta-analysis.

Setting: Intensive care unit (ICU).

Patients or participants: Adult patients requiring vasoactive drugs who received early mobilisation in the intensive care unit.

Interventions: A systematic search was conducted using the databases PubMed, Cochrane Library, Scopus, Medline Ovid, Science Direct, and CINAHL, including observational studies involving adult patients requiring vasoactive drugs who received early mobilisation. A meta-analysis was performed on the proportion of safety events and the proportion of early mobilisation in patients with high, moderate, and low doses of vasoactive drugs.

Main variables of interest: Feasibility, safety events, and the maximum level of activity achieved during early mobilisation.

Results: The search yielded 1875 studies, of which 8 were included in the systematic review and 5 in the meta-analysis. The results showed that 64% (95% CI: 34%-95%, p<0.05) of patients were mobilised with low doses of vasoactive drugs, 30% (95% CI: 7%-53%, p<0.05) with moderate doses, and 7% (95% CI: 3%-16%, p 0.17) with high doses. The proportion of adverse events was low, at 2% (95% CI: 1%-4%, p<0.05).

Conclusions: Early mobilisation in patients with shock and the need for vasoactive drugs is feasible and generally safe. However, there is an emphasis on the need for further high-quality research to confirm these findings.