Effects of the High-Intensity Early Mobilization on Long-Term Functional Status of Patients with Mechanical Ventilation in the Intensive Care Unit
Chuanlin Zhang, Xueqin Wang, Jie Mi, Zeju Zhang, Xinyi Luo, Ruiying Gan, Shaoyu Mu
Critical Care Research and Practice, doi:10.1155/2024/4118896
Objective. Intensive care unit (ICU)-acquired weakness often occurs in patients with invasive mechanical ventilation (IMV). Early active mobility may reduce ICU-acquired weakness, improve functional status, and reduce disability. Te aim of this study was to investigate whether high-intensity early mobility improves post-ICU discharge functional status of IMV patients. Methods. 132 adult patients in the ICU who were undergoing IMV were randomly assigned into two groups with a ratio of 1 : 1, with one group received high-intensity early mobility (intervention group, IG), while the other group received conventional treatment (control group, CG). Te functional status (Barthel Index (BI)), capacity of mobility (Perme score and ICU Mobility Scale (IMS)), muscle strength (Medical Research Council sum scores (MRC-SS)), mortality, complication, length of ICU stay, and duration of IMV were evaluated at ICU discharge or after 3-month of ICU discharge. Results. Te patient's functional status was improved (BI scores 90.6 ± 18.0 in IG vs. 77.7 ± 27.9 in CG; p � 0.005), and capacity of mobility was increased (Perme score 17.6 ± 7.1 in IG vs. 12.2 ± 8.5 in CG, p < 0.001; IMS 4.7 ± 2.6 in IG vs. 3.0 ± 2.6 in CG, p < 0.001). Te IG had a higher muscle strength and lower incidence of ICU-acquired weakness (ICUAW) than that in the CG. Te incidence of mortality and delirium was also lower than CG at ICU discharge. However, there were no diferences in terms of length of ICU stay, duration of IMV, ventilator-associated pneumonia, and venous thrombosis. Conclusions. High-intensity early mobility improved the patient's functional status and increased capacity of mobility with IMV. Te benefts to functional status remained after 3 month of ICU discharge. Other benefts included higher muscle strength, lower incidence of ICUAW, mortality, and delirium in IG.
Ethical Approval Te studies involving human participants were reviewed and approved by the Ethics Committee of the First Afliated Hospital of Chongqing Medical University (Document No. 2018-015).
Consent Te patients/participants provided their written informed consent to participate in this study. Written informed consent was obtained from the individual(s) for the publication of any identifable images or data included in this article.
Conflicts of Interest Te authors declare that they have no conficts of interest.
Authors' Contributions MI J and ZHANG CL were involved in the study design and critical revision of the manuscript. WANG XQ, ZHANG ZJ, GAN RY, LUO XY, and MU SY were involved in drafting of the manuscript. All the authors approved the fnal version of the manuscript, including the authorship list.
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