Original Article
The effect of early mobilization for critical ill patients requiring mechanical ventilation: a systematic review and meta-analysis
Abstract
Background: In recent years, there are increasing number of new studies and researches about early mobilization, an update meta-analysis based on high quality studies and focusing on the effectiveness of early mobilization is quite necessary. The purpose of the article is to explore the effect and safety of early mobilization on reducing the length of stay (LOS) and duration of mechanical ventilation in patients undergoing mechanical ventilation in intensive care unit.
Methods: The databases PubMed, Scopus, EBSCO and Embase were systematically searched. We designed a search strategy for PubMed that consists of terms related to early mobilization and intensive care unit (ICU). We reported mean difference (MD) and 95% CI for LOS in ICU and hospital, the duration of mechanical ventilation, and reported odds ratio (OR) and 95% CI for mortality at hospital discharge.
Results: In total, there were 18 research articles included in the meta-analysis. The early mobilization in intervention group appeared to have positive influence on hospital outcomes with the LOS in ICU (MD =−1.75, 95% CI: −2.70 to −0.79; P=0.0003) and duration of mechanical ventilation (MD =−1.64, 95% CI: −2.41 to −0.87; P<0.0001) significantly decreased. And there was no statistical difference in the analysis of length of hospital stay (MD =−1.58, 95% CI: −4.02 to 0.86; P=0.21) and mortality at hospital charge (OR =1.10, 95% CI: 0.76 to 1.59; P=0.62).
Conclusions: Early mobilization in ICU has positive and safe influence on hospital outcomes in mechanical ventilation patients. It confers significant benefit in decreasing the duration of mechanical ventilation and the LOS in ICU. Furthermore, the early mobilization therapy in ICU will not increase mortality at hospital discharge in a research setting.
Methods: The databases PubMed, Scopus, EBSCO and Embase were systematically searched. We designed a search strategy for PubMed that consists of terms related to early mobilization and intensive care unit (ICU). We reported mean difference (MD) and 95% CI for LOS in ICU and hospital, the duration of mechanical ventilation, and reported odds ratio (OR) and 95% CI for mortality at hospital discharge.
Results: In total, there were 18 research articles included in the meta-analysis. The early mobilization in intervention group appeared to have positive influence on hospital outcomes with the LOS in ICU (MD =−1.75, 95% CI: −2.70 to −0.79; P=0.0003) and duration of mechanical ventilation (MD =−1.64, 95% CI: −2.41 to −0.87; P<0.0001) significantly decreased. And there was no statistical difference in the analysis of length of hospital stay (MD =−1.58, 95% CI: −4.02 to 0.86; P=0.21) and mortality at hospital charge (OR =1.10, 95% CI: 0.76 to 1.59; P=0.62).
Conclusions: Early mobilization in ICU has positive and safe influence on hospital outcomes in mechanical ventilation patients. It confers significant benefit in decreasing the duration of mechanical ventilation and the LOS in ICU. Furthermore, the early mobilization therapy in ICU will not increase mortality at hospital discharge in a research setting.
