Article

OBJECTIVE: To investigate the effectiveness and safety of active mobilization on
improving physical function and hospital outcomes in patients undergoing
mechanical ventilation for more than 24 hours. DATA SOURCES: PubMed, Embase,
CINAHL, CENTRAL, Physiotherapy Evidence Database, SinoMed, and ISI Web of
Knowledge were searched for randomized controlled trials (RCTs), quasi-RCTs,
other comparative studies, and case series with 10 or more consecutive cases.
Additional studies were identified through references, citation tracking, and by
contacting the authors of eligible studies. STUDY SELECTION: Two reviewers
independently selected potential studies according to the inclusion criteria.
DATA EXTRACTION: Two reviewers independently extracted data and assessed the
methodologic quality. DATA SYNTHESIS: A narrative form was used to summarize
study characteristics and outcomes, because the substantial heterogeneity between
the individual studies precluded formal meta-analyses. Among the 17 eligible
studies, 7 RCTs, 1 quasi-RCT, 1 prospective cohort study, and 1 history
controlled study were used to examine the effectiveness; and 2 RCTs, 1
prospective cohort study, and 7 case series were used to examine the safety of
active mobilization in patients receiving mechanical ventilation for more than 24
hours. We found that active mobilization may improve muscle strength, functional
independence, and the ability to wean from ventilation and may decrease the
length of stay in the intensive care unit (ICU) and hospital. However, only 1
study reported that active mobilization reduced the 1-year mortality rate. No
serious adverse events were reported among included studies. CONCLUSIONS: Active
mobilization appears to have a positive effect on physical function and hospital
outcomes in mechanical ventilation patients. Early active mobilization protocols
may be initiated safely in the ICU setting and continued in post-ICU settings.
However, the current available studies have great heterogeneity and limited
methodologic quality. Further research is needed to provide more robust evidence
to support the effectiveness and safety of active mobilization.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS