How safe is early mobilization in the ICU?
Providing physical therapy early in the ICU is a recommended practice that appears to prevent ICU-related weakness at the time of discharge, based on limited evidence. Any longer-term benefits remain unknown, due to a paucity of research.
“Early mobilization” has no standard definition, but can include ambulating patients on ventilators or even ECMO. Is this safe?
Both a 2019 meta-analysis and a large 2022 trial by the ANZICS group raised concerns about increased adverse events among patients receiving intensive physical therapy in the ICU. Neither study showed any effects of early mobilization on mortality.
A new meta-analysis provides some more information on the safety of early mobilization in the ICU. Authors analyzed 59 randomized trials comprising approximately 7000 patients, the majority of whom were mechanically ventilated during physical therapy.
The overall adverse event rate was about 3%, with nearly all events (such as hypoxemia, arrhythmias, and falls) resolving with inte…
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