Early mobilization of the critically Ill patient: literature systematic review

Abstract

Introduction: The immobility and prolonged bed rest, to which the critically ill patient admitted to the intensive care unit is subjected, are harmful and have potential adverse effects, especially on the musculoskeletal system and, consequently, on motor functionality. Objectives: To characterize the impact of early mobilization on the critical patient admitted to an intensive care unit. Method: Systematic review of the literature that used the PI[C]OD methodology to compile the research question, which led to the search in the EBSCOHost search engine, in the CINAHL Complete and MEDLINE Complete databases, for the identification of studies published between 2016 and 2019. Four systematic reviews of the literature and three randomized controlled trials were selected. This review considered the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendation. Levels of evidence were secured by the levels of evidence from The Joanna Briggs Institute and methodological quality was analyzed using the Critical Appraisal Skills Program. Results: Most of the articles included in this review point to the benefits of early mobilization in intensive care units, mainly for the improvement of motor functionality and functional capacity, and only one revision, due to the poor quality of the articles included, is inconclusive to the benefits of this intervention in this population. Conclusions: Early mobilization is a feasible, beneficial, and safe intervention for the critical patient admitted to an intensive care unit. However, due to the lack of studies on the subject and the limitations of the studies analyzed, it is suggested that more quantitative studies, with more representative samples, be carried out.