Fuest Kristina, Schaller Stefan J
Klinikum rechts der Isar, Klinik für Anästhesiologie und Intensivmedizin, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland.
Med Klin Intensivmed Notfmed. 2019 Nov;114(8):759-764. doi: 10.1007/s00063-019-0605-4. Epub 2019 Aug 19.
Early mobilization is defined as intervention within the first 72 h after intensive care unit (ICU) admission. According to the current state of relevant studies, evidence on early mobilization in critically ill patients is still inconsistent. This leads to insecurity in caretakers and subsequently to incomplete implementation in German ICUs.
What type of intervention is suitable for certain patient groups? Which issues remain unresolved?
To obtain best possible outcomes, early mobilization should be initiated during the first 72 h after ICU admission. Implementation of early mobilization improves clinical outcome and should be integrated in a patient-centered bundle (such as ABCDEF). Mechanical ventilation is not a contraindication to intervention. Evidence in neurocritical care as well as functionally dependent patients is still low. Mode of intervention and dosage of early mobilisation remain unclear.
Early mobilization is safe and feasible, resulting in improved outcomes in surgical and medical ICU patients. Further studies are necessary to evaluate the optimal dosage and duration of intervention, especially in neurocritical care patients.
早期活动被定义为在重症监护病房（ICU）入院后72小时内进行的干预。根据相关研究的现状，危重症患者早期活动的证据仍然不一致。这导致护理人员缺乏安全感，进而导致德国ICU的实施不完整。
哪种类型的干预适合某些患者群体？哪些问题仍未解决？
为了获得尽可能好的结果，应在ICU入院后的头72小时内开始早期活动。早期活动的实施可改善临床结果，应纳入以患者为中心的综合措施（如ABCDEF）。机械通气不是干预的禁忌症。神经重症监护以及功能依赖患者的证据仍然不足。早期活动的干预方式和剂量仍不清楚。
早期活动是安全可行的，可改善外科和内科ICU患者的预后。有必要进一步研究以评估干预的最佳剂量和持续时间，特别是在神经重症监护患者中。
