Adler Joseph, Malone Daniel
Good Shepherd Penn Partners at The Hospital of the University of Pennsylvania, Philadelphia, PA.
Cardiopulm Phys Ther J. 2012 Mar;23(1):5-13.
The purpose of this review is to evaluate the literature related to mobilization of the critically ill patient with an emphasis on functional outcomes and patient safety.
We searched the electronic databases of PubMed, CINAHL, Medline (Ovid), and The Cochrane Library for a period spanning 2000-2011. Articles used in this review included randomized and nonrandomized clinical trials, prospective and retrospective analyses, and case series in peer-reviewed journals. Sackett's Levels of Evidence were used to classify the current literature to evaluate the strength of the outcomes reported.
Fifteen studies met inclusion criteria and were reviewed. According to Sackett's Levels of Evidence, 9 studies were level 4 evidence, one study was level 3, 4 studies were level 2, and one study was level one evidence. Ten studies pertained to patient safety/feasibility and 10 studies pertained to functional outcomes with 5 fitting into both categories.
A search of the scientific literature revealed a limited number of studies that examined the mobilization of critically ill patients in the intensive care unit. However, literature that does exist supports early mobilization and physical therapy as a safe and effective intervention that can have a significant impact on functional outcomes.
本综述的目的是评估与重症患者活动相关的文献，重点关注功能结局和患者安全。
我们检索了2000年至2011年期间的PubMed、CINAHL、Medline（Ovid）和Cochrane图书馆的电子数据库。本综述中使用的文章包括同行评审期刊上的随机和非随机临床试验、前瞻性和回顾性分析以及病例系列。采用Sackett证据等级对当前文献进行分类，以评估所报告结局的强度。
15项研究符合纳入标准并进行了综述。根据Sackett证据等级，9项研究为4级证据，1项研究为3级，4项研究为2级，1项研究为1级证据。10项研究涉及患者安全/可行性，10项研究涉及功能结局，其中5项同时属于这两个类别。
对科学文献的检索发现，研究重症监护病房重症患者活动的研究数量有限。然而，现有文献支持早期活动和物理治疗是一种安全有效的干预措施，可对功能结局产生重大影响。
