Effects of the High-Intensity Early Mobilization on Long-Term Functional Status of Patients with Mechanical Ventilation in the Intensive Care Unit

Objective. Intensive care unit (ICU)-acquired weakness often occurs in patients with invasive mechanical ventilation (IMV). Early active mobility may reduce ICU-acquired weakness, improve functional status, and reduce disability. The aim of this study was to investigate whether high-intensity early...

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Main Authors: Chuanlin Zhang, Xueqin Wang, Jie Mi, Zeju Zhang, Xinyi Luo, Ruiying Gan, Shaoyu Mu
Format: Article
Language:English
Published: Wiley 2024-01-01
Series:Critical Care Research and Practice
Online Access:http://dx.doi.org/10.1155/2024/4118896
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author Chuanlin Zhang
Xueqin Wang
Jie Mi
Zeju Zhang
Xinyi Luo
Ruiying Gan
Shaoyu Mu
author_facet Chuanlin Zhang
Xueqin Wang
Jie Mi
Zeju Zhang
Xinyi Luo
Ruiying Gan
Shaoyu Mu
author_sort Chuanlin Zhang
collection DOAJ
description Objective. Intensive care unit (ICU)-acquired weakness often occurs in patients with invasive mechanical ventilation (IMV). Early active mobility may reduce ICU-acquired weakness, improve functional status, and reduce disability. The aim of this study was to investigate whether high-intensity early mobility improves post-ICU discharge functional status of IMV patients. Methods. 132 adult patients in the ICU who were undergoing IMV were randomly assigned into two groups with a ratio of 1 : 1, with one group received high-intensity early mobility (intervention group, IG), while the other group received conventional treatment (control group, CG). The functional status (Barthel Index (BI)), capacity of mobility (Perme score and ICU Mobility Scale (IMS)), muscle strength (Medical Research Council sum scores (MRC-SS)), mortality, complication, length of ICU stay, and duration of IMV were evaluated at ICU discharge or after 3-month of ICU discharge. Results. The patient’s functional status was improved (BI scores 90.6 ± 18.0 in IG vs. 77.7 ± 27.9 in CG; p=0.005), and capacity of mobility was increased (Perme score 17.6 ± 7.1 in IG vs. 12.2 ± 8.5 in CG, p<0.001; IMS 4.7 ± 2.6 in IG vs. 3.0 ± 2.6 in CG, p<0.001). The IG had a higher muscle strength and lower incidence of ICU-acquired weakness (ICUAW) than that in the CG. The incidence of mortality and delirium was also lower than CG at ICU discharge. However, there were no differences in terms of length of ICU stay, duration of IMV, ventilator-associated pneumonia, and venous thrombosis. Conclusions. High-intensity early mobility improved the patient’s functional status and increased capacity of mobility with IMV. The benefits to functional status remained after 3 month of ICU discharge. Other benefits included higher muscle strength, lower incidence of ICUAW, mortality, and delirium in IG.
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spelling doaj-art-059382d07a7d49ac89838e779ad1710f2025-08-20T03:54:28ZengWileyCritical Care Research and Practice2090-13132024-01-01202410.1155/2024/4118896Effects of the High-Intensity Early Mobilization on Long-Term Functional Status of Patients with Mechanical Ventilation in the Intensive Care UnitChuanlin Zhang0Xueqin Wang1Jie Mi2Zeju Zhang3Xinyi Luo4Ruiying Gan5Shaoyu Mu6Department of Critical Care MedicineDepartment of Critical Care MedicineDepartment of Critical Care MedicineSchool of NursingDepartment of Critical Care MedicineDepartment of Critical Care MedicineSchool of NursingObjective. Intensive care unit (ICU)-acquired weakness often occurs in patients with invasive mechanical ventilation (IMV). Early active mobility may reduce ICU-acquired weakness, improve functional status, and reduce disability. The aim of this study was to investigate whether high-intensity early mobility improves post-ICU discharge functional status of IMV patients. Methods. 132 adult patients in the ICU who were undergoing IMV were randomly assigned into two groups with a ratio of 1 : 1, with one group received high-intensity early mobility (intervention group, IG), while the other group received conventional treatment (control group, CG). The functional status (Barthel Index (BI)), capacity of mobility (Perme score and ICU Mobility Scale (IMS)), muscle strength (Medical Research Council sum scores (MRC-SS)), mortality, complication, length of ICU stay, and duration of IMV were evaluated at ICU discharge or after 3-month of ICU discharge. Results. The patient’s functional status was improved (BI scores 90.6 ± 18.0 in IG vs. 77.7 ± 27.9 in CG; p=0.005), and capacity of mobility was increased (Perme score 17.6 ± 7.1 in IG vs. 12.2 ± 8.5 in CG, p<0.001; IMS 4.7 ± 2.6 in IG vs. 3.0 ± 2.6 in CG, p<0.001). The IG had a higher muscle strength and lower incidence of ICU-acquired weakness (ICUAW) than that in the CG. The incidence of mortality and delirium was also lower than CG at ICU discharge. However, there were no differences in terms of length of ICU stay, duration of IMV, ventilator-associated pneumonia, and venous thrombosis. Conclusions. High-intensity early mobility improved the patient’s functional status and increased capacity of mobility with IMV. The benefits to functional status remained after 3 month of ICU discharge. Other benefits included higher muscle strength, lower incidence of ICUAW, mortality, and delirium in IG.http://dx.doi.org/10.1155/2024/4118896
spellingShingle Chuanlin Zhang
Xueqin Wang
Jie Mi
Zeju Zhang
Xinyi Luo
Ruiying Gan
Shaoyu Mu
Effects of the High-Intensity Early Mobilization on Long-Term Functional Status of Patients with Mechanical Ventilation in the Intensive Care Unit
Critical Care Research and Practice
title Effects of the High-Intensity Early Mobilization on Long-Term Functional Status of Patients with Mechanical Ventilation in the Intensive Care Unit
title_full Effects of the High-Intensity Early Mobilization on Long-Term Functional Status of Patients with Mechanical Ventilation in the Intensive Care Unit
title_fullStr Effects of the High-Intensity Early Mobilization on Long-Term Functional Status of Patients with Mechanical Ventilation in the Intensive Care Unit
title_full_unstemmed Effects of the High-Intensity Early Mobilization on Long-Term Functional Status of Patients with Mechanical Ventilation in the Intensive Care Unit
title_short Effects of the High-Intensity Early Mobilization on Long-Term Functional Status of Patients with Mechanical Ventilation in the Intensive Care Unit
title_sort effects of the high intensity early mobilization on long term functional status of patients with mechanical ventilation in the intensive care unit
url http://dx.doi.org/10.1155/2024/4118896
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