Skip to main content

Advertisement

Table 4 Multihospital common early mobilization protocol

From: Determinants of gait independence after mechanical ventilation in the intensive care unit: a Japanese multicenter retrospective exploratory cohort study

Level 1 respiratory (RASS − 5 approximately to – 3) Level 2 HOB (RASS ≥ − 3) Level 3 sitting (RASS ≥ − 1) Level 4 standing (RASS ≥ 0) Level 5 gait (RASS ≥ 0)
Physical therapy
□ Passive ROM exercise
□ Respiratory physical therapy
Physical therapy
□ Positioning
□ Passive ROM exercise
□ Active ROM exercise
□ Respiratory physical therapy
□ Continuous lateral rotation therapy
Physical therapy
□ Positioning
□ Passive ROM exercise
□ Active ROM exercise
□ Sitting at side of bed
□ Rising from the supine position
Physical therapy
□ Positioning
□ Passive ROM exercise
□ Active ROM exercise
□ Standing at side of bed
□ Stand and pivot to a chair
Physical therapy
□ Positioning
□ Passive ROM exercise
□ Active ROM exercise
□ Walk with assistance
□ Walk independently
Positioning
□ Posture change
□ HOB ≤ 45 degrees
Positioning
□ Posture change
□ HOB ≥ 60
Positioning
□ Posture change
□ HOB ≥ 60
Positioning
□ Posture change
□ HOB ≥ 60
Positioning
□ Posture change
□ HOB ≥ 60
Step up criterion
□ Oxygenation/hemodynamic stability
□ Can withstand posture change
□ Can withstand HOB ≤ 45 degrees
Step up criterion
□ Can withstand supplementary motion of physical therapy
□ Can withstand HOB ≤ 60 degrees
□ Anti-gravity movement possible
Step up criterion
□ Can endure the active movement of physical therapy
□ Can withstand HOB ≤ 60 degrees
□ Can withstand sitting at side of bed
Step up criterion
□ All exercise can be carried out
□ Can withstand partial weight standing
Step up criterion
□ Increase walking distance gradually
Step up criterion to level 3 or higher are defined as:
RASS − 1 to + 2, BPS ≤ 3 or NRS ≤ 5, SpO2 ≥ 91%, FIO2 > 0.6, respiratory rate < 30 times/min, systolic blood pressure 90 to 180 mmHg, mean blood pressure 65 to 110 mmHg, heart rate 60 to 120 times/min, there were no new arrhythmias, no additional administration of vasopressors, no bleeding, no wound with the possibility of separation, and no unstable fracture.
  1. RASS Richmond Agitation-Sedation Scale, ROM range of motion, HOB head of bed, BPS behavioral pain scale, NRS numeric rating scale