1Nursing Research, Nursing and Patient Service, University Hospital of Schleswig-Holstein, Campus Kiel, Germany. 2Outcomes After Critical Illness and Surgery (OACIS) Group, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD. 3Critical Care Medicine Department, National Institutes of Health, Clinical Center, Bethesda, MD. 4Faculty of Nursing Science, University of Witten-Herdecke, Witten, Germany. 5Department of Anaesthesiology and Operative Intensive Care Medicine, Katharinenhospital, Klinikum Stuttgart, Stuttgart, Germany. 6Department of Physiotherapy, University Hospital of Gießen and Marburg GmbH, Marburg, Germany. 7Work and Life Educational Association, Göttingen, Germany. 8Department of Continuing Education of Critical Care Nursing, District Hospital of Reutlingen, Reutlingen, Germany. 9Department of Anaesthesiology and Intensive Care Medicine, Alb Fils Kliniken GmbH, Klinik am Eichert, Göppingen, Germany. 10Department of Anaesthesiology, Emergency and Intensive Care Medicine, University Hospital of Göttingen, Göttingen, Germany. 11Department of Anaesthesia and Intensive Care Medicine, Zentralklinik Bad Berka, Bad Berka, Germany. 12Department of Medicine, University Hospital Tübingen, Tübingen, Germany. 13Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD.
Crit Care Med. 2014 May;42(5):1178-86. doi: 10.1097/CCM.0000000000000149.
There is growing evidence to support early mobilization of adult mechanically ventilated patients in ICUs. However, there is little knowledge regarding early mobilization in routine ICU practice. Hence, the interdisciplinary German ICU Network for Early Mobilization undertook a 1-day point-prevalence survey across Germany.
One-day point-prevalence study.
One hundred sixteen ICUs in Germany in 2011.
All adult mechanically ventilated patients.
None.
For a 24-hour period, data were abstracted on hospital and ICU characteristics, the level of patient mobilization and associated barriers, and complications occurring during mobilization. One hundred sixteen participating ICUs provided data for 783 patients. Overall, 185 patients (24%) were mobilized out of bed (i.e., sitting on the edge of the bed or higher level of mobilization). Among patients with an endotracheal tube, tracheostomy, and noninvasive ventilation, 8%, 39%, and 53% were mobilized out of bed, respectively (p < 0.001 for difference between three groups). The most common perceived barriers to mobilizing patients out of bed were cardiovascular instability (17%) and deep sedation (15%). Mobilization out of bed versus remaining in bed was not associated with a higher frequency of complications, with no falls or extubations occurring in those mobilized out of bed.
In this 1-day point-prevalence study conducted across Germany, only 24% of all mechanically ventilated patients and only 8% of patients with an endotracheal tube were mobilized out of bed as part of routine care. Addressing modifiable barriers for mobilization, such as deep sedation, will be important to increase mobilization in German ICUs.
越来越多的证据支持对 ICU 中的成年机械通气患者进行早期活动。然而，关于常规 ICU 实践中的早期活动，我们知之甚少。因此，跨学科的德国 ICU 早期活动网络在德国进行了为期一天的患病率调查。
一天的患病率研究。
德国 2011 年的 116 个 ICU。
所有接受机械通气的成年患者。
无。
在 24 小时内，收集了医院和 ICU 特征、患者活动水平和相关障碍、以及在活动过程中发生的并发症的数据。116 个参与的 ICU 为 783 名患者提供了数据。总体而言，185 名患者（24%）被从床上移到（即坐在床边或更高水平的活动）。在有气管插管、气管切开和无创通气的患者中，分别有 8%、39%和 53%被从床上移到（三组之间的差异 p < 0.001）。认为阻碍患者从床上活动的最常见障碍是心血管不稳定（17%）和深度镇静（15%）。与留在床上相比，从床上移动与并发症发生频率增加无关，在从床上移动的患者中没有跌倒或拔管发生。
在德国进行的这项为期一天的患病率研究中，只有 24%的所有机械通气患者和只有 8%的气管插管患者被作为常规护理的一部分从床上移到。解决可移动性障碍，如深度镇静，对于增加德国 ICU 的活动量将非常重要。
