Table 1 Proposed criteria for initiation of mobilization and exercise therapy in critically ill patients
Category | Item/Index | Acceptance criterion value or condition |
|---|---|---|
Subjective symptoms | Pain | (If self-reported) NRS ≤ 3 or VAS ≤ 30 mm |
(If not self-reported) BPS ≤ 5 or CPOT ≤ 2 | ||
No intolerable pain/agony | ||
Fatigue | No intolerable fatigue | |
Dyspnea | No sudden dyspnea | |
Neurological | Sedation, agitation (RASS) | -2 ≤ RASS ≤ + 1 (If there is not enough staff for safety management) RASS + 2 is acceptable |
Consciousness level (GCS and JCS) | Opens eyes when called upon | |
Respiratory | Respiratory rate | 5 breaths per minute ≤ RR ≤ 40 breaths per minute |
Percutaneous arterial oxygen saturation (SpO2) | SpO2 ≥ 88% or ≥ 90% | |
Fraction of inspiratory oxygen (FIO2) | FIO2 < 0.6 | |
Positive end-expiratory pressure (PEEP) | PEEP < 10 cmH2O | |
Guidelines for mechanical ventilation management | Not set for lung rest | |
Cardiovascular system | Heart rate | 40 bpm ≤ HR ≤ 130 bpm |
Systolic blood pressure | 90 mmHg ≤ sBP ≤ 180 mmHg | |
Mean arterial pressure | 60 mmHg ≤ MAP ≤ 100 mmHg | |
Dose of hypertensive drug | No recent new drug initiation or dose increase prior to the start | |
Arrhythmia | No arrhythmia that could disrupt the hemodynamics | |
Myocardial ischemia | No ECG changes suggestive of new myocardial ischemia or no untreated myocardial ischemia | |
Device | Device and catheter | Insertion site is properly immobilized |
Other | Intracranial pressure | ICP < 20 mmHg and no recent increase in ICP prior to start |
Body temperature | BT < 38.5ºC Not undergoing hypothermia therapy | |
Bleeding | No active bleeding Hemoglobin concentration ≥ 7 g/dL | |
Skeletal system | No unstable fractures | |
Cerebrovascular event | No cerebrovascular events within 24 h | |
Thromboembolism | Thromboembolism is under control | |
Organ ischemia | No new-onset or uncontrolled organ ischemia |