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.