Cameron Saoirse, Ball Ian, Cepinskas Gediminas, Choong Karen, Doherty Timothy J, Ellis Christopher G, Martin Claudio M, Mele Tina S, Sharpe Michael, Shoemaker J Kevin, Fraser Douglas D
Functional Recovery in Critically Ill Children: The "Wee-Cover" Longitudinal Cohort Study; Targeted Exercise to Reduce Morbidity and Mortality in Severe Sepsis (TERMS) Study.
Targeted Exercise to Reduce Morbidity and Mortality in Severe Sepsis (TERMS) Study; Medicine, Western University, London, ON, Canada.
J Crit Care. 2015 Aug;30(4):664-72. doi: 10.1016/j.jcrc.2015.03.032. Epub 2015 Apr 8.
Early mobilization of critically ill patients is beneficial, suggesting that it should be incorporated into daily clinical practice. Early passive, active, and combined progressive mobilizations can be safely initiated in intensive care units (ICUs). Adult patients receiving early mobilization have fewer ventilator-dependent days, shorter ICU and hospital stays, and better functional outcomes. Pediatric ICU data are limited, but recent studies also suggest that early mobilization is achievable without increasing patient risk. In this review, we provide a current and comprehensive appraisal of ICU mobilization techniques in both adult and pediatric critically ill patients. Contraindications and perceived barriers to early mobilization, including cost and health care provider views, are identified. Methods of overcoming barriers to early mobilization and enhancing sustainability of mobilization programs are discussed. Optimization of patient outcomes will require further studies on mobilization timing and intensity, particularly within specific ICU populations.
危重症患者的早期活动有益，这表明应将其纳入日常临床实践。在重症监护病房（ICU）中，可以安全地启动早期被动、主动和联合渐进性活动。接受早期活动的成年患者机械通气依赖天数减少，ICU和住院时间缩短，功能预后更好。儿科ICU的数据有限，但最近的研究也表明，早期活动是可行的，且不会增加患者风险。在本综述中，我们对成人和儿科危重症患者的ICU活动技术进行了当前全面的评估。确定了早期活动的禁忌症和公认障碍，包括成本和医疗保健提供者的观点。讨论了克服早期活动障碍和提高活动计划可持续性的方法。要优化患者预后，需要进一步研究活动时机和强度，尤其是在特定的ICU人群中。
