Bento Inês, Ferreira Bruno, Baixinho Cristina Lavareda, Henriques Maria Adriana
Nursing Department, Red Cross Higher School of Health, 1300-125 Lisbon, Portugal.
Nursing School of Lisbon, University of Lisbon, 1649-004 Lisbon, Portugal.
Nurs Rep. 2025 Feb 20;15(3):75. doi: 10.3390/nursrep15030075.
: Post Intensive Care Syndrome (PICS) is a set of physical, cognitive, and mental health symptoms that arise following intensive care (ICU) hospitalization. Regarding physical changes, muscle weakness is highlighted, potentially leading to functional impairments during and after hospitalization. Multidisciplinary guidelines recommend early mobilization, a rehabilitation intervention, as a strategy to prevent ICU-acquired muscle weakness and reduce functionality impairments. : This study aims to evaluate the effectiveness of early mobilization and positioning interventions to prevent or minimize ICU-acquired weakness in critically ill patients under invasive mechanical ventilation (IMV). : A systematic review of effectiveness will be conducted following Cochrane recommendations. Searches will be made in MEDLINE (via PubMed), CINAHL, Scopus, and Web of Science. Eligible studies will include randomized controlled trials on the functional management of muscle weakness, muscle strength, and ICU-acquired muscle weakness in adults (≥18 years) who have undergone IMV. Eligible interventions (and comparators) include any manual mobilization and positioning strategy or the use of medical devices. Two reviewers will independently select studies, extract data using a piloted tool and assess bias with the RoB 2 tool. If appropriate, a meta-analysis will be conducted, pooling standardized mean differences using a random-effects model. : This review included primary experimental studies manipulating at least one variable, control group studies, or randomized trials comparing early intervention protocols, programs, or plans with standard care or existing approaches in the ICU. : This review will provide meaningful comparisons of different mobilization and positioning strategies, evaluating their impact on muscle strength and functionality in critically ill patients. Systematic Review Registration: PROSPERO CRD4202348091.
重症监护后综合征（PICS）是指在重症监护病房（ICU）住院后出现的一系列身体、认知和心理健康症状。关于身体变化，肌肉无力较为突出，这可能导致住院期间及出院后出现功能障碍。多学科指南推荐早期活动，这是一种康复干预措施，作为预防ICU获得性肌肉无力和减少功能障碍的策略。本研究旨在评估早期活动和体位干预对预防或减轻接受有创机械通气（IMV）的危重症患者ICU获得性肌无力的有效性。将按照Cochrane推荐进行有效性的系统评价。检索将在MEDLINE（通过PubMed）、CINAHL、Scopus和Web of Science中进行。符合条件的研究将包括对接受IMV的成年人（≥18岁）的肌肉无力功能管理、肌肉力量和ICU获得性肌肉无力的随机对照试验。符合条件的干预措施（和对照）包括任何手动活动和体位策略或使用医疗设备。两名评审员将独立选择研究，使用预先测试的工具提取数据，并使用RoB 2工具评估偏倚。如果合适，将进行荟萃分析，使用随机效应模型汇总标准化平均差。本综述纳入了至少操纵一个变量的原发性实验研究、对照组研究或比较ICU早期干预方案、计划或规划与标准护理或现有方法的随机试验。本综述将对不同的活动和体位策略进行有意义的比较，评估它们对危重症患者肌肉力量和功能的影响。系统评价注册：PROSPERO CRD4202348091。
