EARLY MOBILIZATION IN INTENSIVE CARE: A NARRATIVE REVIEW

Early mobility of the critically ill patients admitted in intensive care units (ICUs) has been recommended as key strategies of care intended to prevent the complications that are attributed to long time bed rest. This grounded review critically evaluates available literature to analyse the evidence for early mobilization in the ICU, its advantages, risks and concerns on practice delivery. Various studies indicate that different levels of early mobilization have a potential to lower the incidences of developing ICU-acquired weakness, reduce mechanical ventilation length, lessen delirium eventually enhancing the functional outcome. Recent evidence has established that early mobility is safe in the majority of the critically ill patients including those receiving mechanical ventilation provided that certain criteria however, are used in implementing the same. Though, evidence exists in favor of early mobilization the way remains improsrved due to safety concerns related to patient mobility and risks, insufficient resources, ineffective role interprofessional collaboration as well as lack of standard guidelines. It entails invoking multi-professional strategies, defining standard operating procedures, provision of adequate resources and staff training. In the recent years, new mobilization technologies such as cycling on bed, neuromuscular electrical stimulation, new equipment and complex have added different forms of early activity programs for patients with many disabilities. Is disappointing that few studies reported on adverse effects of the mobilization interventions and more research needs to be conducted to establish dosing regimen that will elicit the best response, predictors of response and ways of measuring the effects for comparison between mobilization procedures. Being a part of progressive critical care that adjusts to the patient-centered care delivery early mobilization could be viewed as one of the key interventions that affect both short and long-term results of ICU treatment.