Table 2 Adverse events during early mobilization
From: Early mobilization of mechanically ventilated patients in the intensive care unit
Reference # | n | Early mobilization intervention | Incidence of adverse events | Adverse events |
|---|---|---|---|---|
[24] | 103 | Active mobilization: 1449 sessions: sitting on bed and in chair, ambulation | 0.96 % | Fall, systolic blood pressure <90 mmHg, oxygen desaturation, feeding tube extraction, systolic blood pressure >200 mmHg |
[3] | 90 | Passive and active therapy, bicycle ergometer exercise | 3.76 % | SpO2 < 90 %, systolic blood pressure >180 mmHg, >20 % decrease in diastolic blood pressure |
[2] | 104 | Passive and active range of motion, sitting, balance exercises, activities of daily living, transfer training, walking | 4.0 % | Patient instability (most often because of perceived patient-ventilator asynchrony), 0.2 % serious (desaturation <80 %) |
[29] | 99 | Active mobilization: 498 sessions | 16 % | Desaturation ≧5 %, heart rate increase >20 %, ventilator asynchrony/tachypnea, agitation/discomfort, device removal |
[25] | 20 | Active mobilization: 424 sessions: chair sitting, head up tilt, walking | 3 % | Decreased muscle tone, hypoxemia, extubation, orthostatic, hypotension |
[4] | 150 | Walking in place, sit to stand transfers, arm and leg active range of motion | None major | – |
[26] | 1110 | Active mobilization: 5267 session: in-bed exercise, in-bed bicycling, sitting, transfer, standing, walking | 0.6 % | Arrhythmia, MAP > 140 mmHg, MAP < 55 mmHg, oxygen desaturation, fall, feeding tube extraction, radial artery catheter removal, chest tube removal |
[27] | 637 | 16-level early progressive mobility protocol | Not validated | – |
[28] | 99 | Active mobilization: 520 sessions | 5 % | Respiratory distress, desaturation, tachypnea or bradycardia, patient’s intolerance, tracheostomy removal |
[5] | 120 | Proper breathing techniques during exercise, progressive range of motion, muscle strengthening exercises, exercises designed to improve core mobility and strength, functional mobility retraining | 0.16 % | Syncopal episode during a PT session, readmitted to the hospital with polyarthralgia |
[6] | 50 | Early goal-directed mobilization | 0.96 % | Fall, systolic blood pressure <90 mmHg, oxygen desaturation, feeding tube extraction, systolic blood pressure >200 mmHg |
[7] | 300 | Passive range of motion, physical therapy, and progressive resistance exercises | 6.0 % | Deaths, device removals, reintubations, and patient falls during physical therapy |