Protocolized strategies to encourage early mobilization of critical care patients: challenges and success.

Critical care science Pub Date : 2025-02-10 eCollection Date: 2025-01-01 DOI:10.62675/2965-2774.20250128
Patrick Sepúlveda, Adrián Gallardo, Ricardo Arriagada, Eduardo González, Patricia Rieken Macedo Rocco, Denise Battaglini
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Abstract

Technological advances and interprofessional teamwork have significantly improved survival rates of critically ill patients. However, this progress has also introduced new challenges, such as intensive care unit-acquired weakness, which can contribute to postintensive care syndrome. Both conditions are associated with increased morbidity and mortality, prolonged length of hospital stay, higher social and health care costs, and reduced quality of life for patients and their families. Timely physical therapy plays a crucial role in mitigating intensive care unit-acquired weakness and postintensive care syndrome. Key recommendations for the effective rehabilitation of patients in the intensive care unit include education and training, communication and collaboration, patient screening, planning of activities, distribution of functions focused on teamwork, patient cooperation, safety assessments, patient positioning, functional mobilization, and documentation of outcomes. This narrative review aims to update the current understanding of the influence of physical therapy and critical care teamwork on intensive care unit patients and to provide evidence-based recommendations for promoting early mobilization in the intensive care unit setting.

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鼓励重症监护患者早期动员的协议化策略:挑战与成功。
技术进步和跨专业合作显著提高了危重病人的生存率。然而,这一进展也带来了新的挑战,例如重症监护病房获得性虚弱,这可能导致重症监护后综合征。这两种情况都与发病率和死亡率增加、住院时间延长、社会和卫生保健费用增加以及患者及其家属生活质量下降有关。及时的物理治疗在减轻重症监护室获得性虚弱和重症监护后综合征中起着至关重要的作用。对重症监护室患者有效康复的主要建议包括教育和培训、沟通和协作、患者筛查、活动规划、以团队合作为重点的功能分配、患者合作、安全评估、患者定位、功能动员和结果记录。这篇叙述性综述旨在更新目前对物理治疗和重症监护团队合作对重症监护病房患者影响的理解,并为促进重症监护病房的早期动员提供循证建议。
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