Wang Lijie, Hua Yusi, Wang Luping, Zou Xia, Zhang Yan, Ou Xiaofeng
Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Front Med (Lausanne). 2023 Jun 28;10:1202754. doi: 10.3389/fmed.2023.1202754. eCollection 2023.
The effects of early mobilization (EM) on intensive care unit (ICU) patients remain unclear. A meta-analysis of randomized controlled trials was performed to evaluate its effect in mechanically ventilated adult ICU patients.
We searched randomized controlled trials (RCTs) published in Medline, Embase, and CENTRAL databases (from inception to November 2022). According to the difference in timing and type, the intervention group was defined as a systematic EM group, and comparator groups were divided into the late mobilization group and the standard EM group. The primary outcome was mortality. The secondary outcomes were ICU length of stay, duration of mechanical ventilation (MV), and adverse events. EM had no impact on 180-day mortality and hospital mortality between intervention groups and comparator groups (RR 1.09, 95% CI 0.89-1.33, = 0.39). Systemic EM reduced the ICU length of stay (LOS) (MD -2.18, 95% CI -4.22--0.13, = 0.04) and the duration of MV (MD -2.27, 95% CI -3.99--0.56, = 0.009), but it may increase the incidence of adverse events in patients compared with the standard EM group (RR 1.99, 95% CI 1.25-3.16, = 0.004).
Systematic EM has no significant effect on short- or long-term mortality in mechanically ventilated adult ICU patients, but systematic EM could reduce the ICU LOS and duration of MV.
早期活动（EM）对重症监护病房（ICU）患者的影响尚不清楚。进行了一项随机对照试验的荟萃分析，以评估其对接受机械通气的成年ICU患者的效果。
我们检索了Medline、Embase和CENTRAL数据库（从创建至2022年11月）中发表的随机对照试验（RCT）。根据时间和类型的差异，干预组被定义为系统性早期活动组，对照组分分为晚期活动组和标准早期活动组。主要结局是死亡率。次要结局是ICU住院时间、机械通气（MV）持续时间和不良事件。早期活动对干预组和对照组之间的180天死亡率和医院死亡率没有影响（风险比1.09，95%置信区间0.89 - 1.33，P = 0.39）。系统性早期活动缩短了ICU住院时间（MD -2.18，95%置信区间 -4.22 - -0.13，P = 0.04）和MV持续时间（MD -2.27，95%置信区间 -3.99 - -0.56，P = 0.009），但与标准早期活动组相比，可能会增加患者不良事件的发生率（风险比1.99，95%置信区间1.25 - 3.16，P = 0.004）。
系统性早期活动对接受机械通气的成年ICU患者的短期或长期死亡率没有显著影响，但系统性早期活动可以缩短ICU住院时间和MV持续时间。
