The Latest in Critical Care, 9/11/23 (Issue #14)
Can early mobility in the ICU improve cognitive outcomes?
Intensive, early mobilization of patients in the ICU seems like it just has to help. Get patients moving as much as possible, as early as possible—walking down the halls trailing their ventilators and arterial lines—and surely it will prevent muscle atrophy, improve strength and mobility, and reduce long-term disability.
But it didn’t, in the largest multicenter randomized trial conducted to date. (At least, not over and above regular physical therapy in the ICU— which most centers have a long way to go yet to achieve.)
Although intensive early mobility didn’t improve physical outcomes, a small study suggests that frequent physical therapy initiated by default early in an ICU stay might improve cognitive outcomes.
About 200 ventilated med-surg ICU patients at a single center (the University of Chicago, where the groundbreaking work of sedation interruptions and breathing trials was originally done) were randomized to receive frequ…
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