Expert consensus and recommendations on safety criteria for active mobilization of mechanically ventilated critically ill adults

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Hodgson, Carol L
Stiller, Kathy
Needham, Dale M
Tipping, Claire J
Harrold, Megan
Baldwin, Claire E
Bradley, Scott
Berney, Sue
Caruana, Lawrence R
Elliott, Doug
Green, Margot
Haines, Kimberley
Higgins, Alisa M
Kaukonen, Kirsi-Maija
Leditschke, Isabel Anne
Nickels, Marc R
Paratz, Jennifer
Patman, Shane
Skinner, Elizabeth H
Young, Paul J
Zanni, Jennifer M
Denehy, Linda
Webb, Steven A
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2014
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Abstract

Introduction: The aim of this study was to develop consensus recommendations on safety parameters for mobilizing adult, mechanically ventilated, intensive care unit (ICU) patients. Methods: A systematic literature review was followed by a meeting of 23 multidisciplinary ICU experts to seek consensus regarding the safe mobilization of mechanically ventilated patients.
Results: Safety considerations were summarized in four categories: respiratory, cardiovascular, neurological and other. Consensus was achieved on all criteria for safe mobilization, with the exception being levels of vasoactive agents. Intubation via an endotracheal tube was not a contraindication to early mobilization and a fraction of inspired oxygen less than 0.6 with a percutaneous oxygen saturation more than 90% and a respiratory rate less than 30 breaths/minute were considered safe criteria for in- and out-of-bed mobilization if there were no other contraindications. At an international meeting, 94 multidisciplinary ICU clinicians concurred with the proposed recommendations.
Conclusion: Consensus recommendations regarding safety criteria for mobilization of adult, mechanically ventilated patients in the ICU have the potential to guide ICU rehabilitation whilst minimizing the risk of adverse events.

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Critical Care

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18

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6

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© Hodgson et al.; licensee BioMed Central. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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Biomedical and clinical sciences

Health and community services

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