Mobilization of prolonged mechanical ventilation patients: An integrative review.
Heather Dunn, Laurie Quinn, Susan J Corbridge and 3 others
PMID 28624337WHAT IT FOUND
Most studies in prolonged mechanical ventilation patients found mobilization improved function and ventilation time, but protocols and outcome definitions varied, and low-quality evidence means benefit is not proven.
No harms were reported.
Key findings
01Across the eight included studies, all but one reported improvements in functional status and shorter duration of mechanical ventilation.
02The mobilization programs varied widely, and the only intervention consistent across all studies was weighted resistance of up to 600 gm.
03Only three randomized trials were included, and their average PEDro score was 5.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The review included only eight studies. The randomized trials had small samples of 27 to 34 participants, and the non-randomized studies had samples of 32 to 190 participants. Study groups were often not equivalent at baseline, including differences in pulmonary mechanics and tracheostomy status. Ventilator liberation was defined differently across studies, and only one study used the NAMDRC seven-day definition. Functional status was often measured with the Functional Independence Measure or Barthel Index, but the review notes validity concerns for these measures in this population. Half of the included studies scored level 4 on Sackett's scale, and the three randomized trials had an average PEDro score of 5. The review searched only published English-language studies and excluded unpublished work and case reports.
The easy way to misread this
Do not conclude that mobilization reliably improves ventilator liberation or survival. The review found inconsistent weaning and hospital outcomes across low-quality studies with different definitions.