Article

Bed rest and immobility in patients on mechanical ventilation or in
an intensive care unit (ICU) have detrimental effects.
Studies in medical ICUs
show that early mobilization is safe, does not increase costs, and can be
associated with decreased ICU and hospital lengths of stay (LOS). The
purpose of this study was to assess the effects of an early mobilization protocol
on complication rates, ventilator days, and ICU and hospital LOS for patients
admitted to a trauma and burn ICU (TBICU).
This was a retrospective
cohort study of an interdisciplinary quality-improvement program. METHODS: Pre-
and post-early mobility program patient data from the trauma registry for 2,176
patients admitted to the TBICU between May 2008 and April 2010 were compared.
RESULTS: No adverse events were reported related to the early mobility program.
After adjusting for age and injury severity, there was a decrease in airway,
pulmonary, and vascular complications (including pneumonia and deep vein
thrombosis) post-early mobility program. Ventilator days and TBICU and hospital
lengths of stay were not significantly decreased. LIMITATIONS: Using a historical
control group, there was no way to account for other changes in patient care that
may have occurred between the 2 periods that could have affected patient
outcomes. The dose of physical activity both before and after the early mobility
program were not specifically assessed. CONCLUSIONS:
Early mobilization of
patients in a TBICU was safe and effective. Medical, nursing, and physical
therapy staff, as well as hospital administrators, have embraced the new culture
of early mobilization in the ICU.

Langue : ANGLAIS