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

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; 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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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...[Show more]

dc.contributor.authorHodgson, Carol L
dc.contributor.authorStiller, Kathy
dc.contributor.authorNeedham, Dale M
dc.contributor.authorTipping, Claire J
dc.contributor.authorHarrold, Megan
dc.contributor.authorBaldwin, Claire E
dc.contributor.authorBradley, Scott
dc.contributor.authorBerney, Sue
dc.contributor.authorCaruana, Lawrence R
dc.contributor.authorElliott, Doug
dc.contributor.authorGreen, Margot
dc.contributor.authorHaines, Kimberley
dc.contributor.authorHiggins, Alisa M
dc.contributor.authorKaukonen, Kirsi-Maija
dc.contributor.authorLeditschke, Isabel
dc.contributor.authorNickels, Marc R
dc.contributor.authorParatz, Jennifer
dc.contributor.authorPatman, Shane
dc.contributor.authorSkinner, Elizabeth H
dc.contributor.authorYoung, Paul J
dc.contributor.authorZanni, Jennifer M
dc.contributor.authorDenehy, Linda
dc.contributor.authorWebb, Steven A
dc.date.accessioned2016-01-18T03:38:12Z
dc.date.available2016-01-18T03:38:12Z
dc.identifier.issn1364-8535
dc.identifier.urihttp://hdl.handle.net/1885/95506
dc.description.abstractINTRODUCTION 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.
dc.description.sponsorshipCH was supported by an Early Career Research Fellowship from the National Health and Medical Research Council (NHMRC) of Australia and the Australian and New Zealand Intensive Care Research Centre, Monash University. ES was supported employed by Western Health.
dc.publisherBioMed Central
dc.rights© 2014 Hodgson et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), 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.
dc.sourceCritical Care
dc.titleExpert consensus and recommendations on safety criteria for active mobilization of mechanically ventilated critically ill adults
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume18
dc.date.issued2014-12-04
local.identifier.absfor110310
local.identifier.ariespublicationa383154xPUB1516
local.publisher.urlhttp://www.biomedcentral.com/
local.type.statusPublished Version
local.contributor.affiliationHodgson, Carol L, Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), Department, Australia
local.contributor.affiliationStiller, Kathy, Department of Physiotherapy, Australia
local.contributor.affiliationNeedham, DM, Outcomes After Critical Illness & Surgery (OACIS) Group, Division of Pulmonary &, United States of America
local.contributor.affiliationTipping, CJ, Department of Physiotherapy, Australia
local.contributor.affiliationHarrold, M, School of Physiotherapy & Exercise Science, Australia
local.contributor.affiliationBaldwin, CE, School of Health Sciences, Australia
local.contributor.affiliationBradley, S, Department of Physiotherapy, Australia
local.contributor.affiliationBerney, S, Physiotherapy Department, Australia
local.contributor.affiliationLeditschke, Isabel, College of Medicine, Biology and Environment, CMBE ANU Medical School, ANU Medical School, The Australian National University
local.contributor.affiliationCaruana, LR, The Prince Charles Hospital, Australia
local.contributor.affiliationElliott, D, Faculty of Health, Australia
local.identifier.essn1466-609X
local.bibliographicCitation.issue6
local.bibliographicCitation.startpage658
local.identifier.doi10.1186/s13054-014-0658-y
dc.date.updated2016-02-24T08:05:31Z
local.identifier.scopusID2-s2.0-84927722146
CollectionsANU Research Publications

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