Abstract:
OBJECTIVES:To evaluate the methodological quality and thematic completeness of existing clinical practice guidelines, addressing early mobilization of adults in the ICU. DATA SOURCES:Systematic review of Medline, Embase, CINAHL, Cochrane, and grey literature from January 2008 to February 2020. STUDY SELECTION:Two reviewers independently screened titles and abstracts and then full texts for eligibility. Ten publications were included. DATA EXTRACTION:A single reviewer extracted data from the included publications and a second reviewer completed cross-checking. Qualitative data were extracted in five categories relating to the key factors influencing delivery of early mobilization to critically ill patients. DATA SYNTHESIS:Methodological quality was appraised using the Appraisal of Guidelines for Research and Evaluation II tool. Appraisal of Guidelines for Research and Evaluation II scores for applicability were low. Median quality scores for editorial independence, rigor of development, and stakeholder engagement were also poor. Narrative synthesis of publication content was undertaken. All publications supported implementation of early mobilization. Most documents agreed upon seven topics: 1) early mobilization is safe and may reduce healthcare costs, 2) safety criteria should be provided, 3) a protocolized or structured approach should be used, 4) collaborative teamwork is required, 5) staff require specific skills or experience, 6) patient and family engagement is important, and 7) program evaluation and outcome measurement are a key component of implementation. There was no consensus on dosage and patient selection. The areas of team culture and leadership were poorly addressed. CONCLUSIONS:Despite significant variation in the methodological quality of clinical practice guidelines for early mobilization, there were important consistencies in recommendations internationally. Future research should address gaps related to patient selection, dosage, team culture, and expertise. Future clinical practice guidelines in this area should focus on engagement of patients and families in the development process and provision of resources to support implementation based on the consideration of known barriers and facilitators.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Lang JK,Paykel MS,Haines KJ,Hodgson CLdoi
10.1097/CCM.0000000000004574subject
Has Abstractpub_date
2020-11-01 00:00:00pages
e1121-e1128issue
11eissn
0090-3493issn
1530-0293journal_volume
48pub_type
杂志文章abstract::To achieve normocarbia during conventional mechanical ventilation, ventilator settings are determined initially on the basis of body weight. The best ventilator settings for CO2 elimination during high-frequency jet ventilation (HFJV) have not been so clearly defined. A recent study has suggested that eucarbia will be...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198801000-00012
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:To assess the agreement between computed tomography and transcranial sonography in patients after decompressive craniectomy. DESIGN:Prospective study. SETTING:The medical intensive care unit of a university-affiliated teaching hospital. PATIENTS:Thirty head-injured patients consecutively admitted to the in...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318246b6ea
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:To determine the financial impact of a sepsis protocol designed for use in the emergency department. DESIGN:Retrospective analysis of a before-after study testing the implications of sepsis protocol. SETTING:Academic, tertiary care hospital in the United States. PATIENTS:Persons with septic shock presentin...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000261886.65063.CC
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:To prospectively evaluate the oxygenation effect of inhaled nitric oxide (INO) delivered during high-frequency oscillatory ventilation in adult patients with the acute respiratory distress syndrome and oxygenation failure. DESIGN Prospective, clinical study. SETTING:Intensive care unit of a university teachi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000049953.86613.02
更新日期:2003-02-01 00:00:00
abstract::We analyzed 35 samples of fresh frozen plasma (FFP), finding mean concentrations of 535 mg/dl glucose, 172 mEq/L sodium, 73 mEq/L chloride, 3.5 mEq/L potassium, 15 mEq/L bicarbonate, and 5.5 g/dl protein with 60% albumin. Thus, FFP is a hyperosmolal, hyperglycemic, hypernatremic, and hypochloremic solution which may b...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198602000-00015
更新日期:1986-02-01 00:00:00
abstract:OBJECTIVE:To determine the significance of moderate elevations of serum troponin I in a surgical intensive care unit patient population in terms of its impact on indexes of outcome including mortality, morbidity, and hospital and intensive care unit length of stay. DESIGN:Retrospective chart review and analysis of cli...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000089931.09635.D2
更新日期:2003-11-01 00:00:00
abstract:OBJECTIVE:To provide a comprehensive review of the issue related to the administration of sedative, analgesic, and neuromuscular blocking agents (NMBA) to patients who are receiving ventilatory support for acute respiratory distress syndrome (ARDS) with high-frequency oscillatory ventilation. RESULTS:Sedative, analges...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.ccm.0000156794.96880.df
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVE:To review the rationale for the regionalization of adult critical care and discuss how lessons from the trauma experience may be relevant to this debate. DESIGN:Narrative review and opinion. RESULTS:Variation in the quality of critical care among hospitals has prompted calls for regionalization of care for ...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e31818c37b2
更新日期:2008-11-01 00:00:00
abstract::Ethical decision-making for the care of the critically ill and injured has never been more difficult than it is today. Major technologic advances prolong life but often provide questionable benefit in human terms. Both the ethical commitment to the individual patient and the competition for access to expensive and sca...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198806000-00015
更新日期:1988-06-01 00:00:00
abstract:OBJECTIVES:To understand when the use of high-frequency ventilation would be advantageous, we formulated the problem of achieving adequate alveolar ventilation at minimal pressure cost by dividing it into two simpler problems: a) the pressure cost per unit of convective oscillatory flow; and b) the convective flow cost...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-199422091-00004
更新日期:1994-09-01 00:00:00
abstract:OBJECTIVE:The goals of this review article are to review the importance and value of standardized definitions in clinical research, as well as to propose the necessary tools and infrastructure needed to advance nosology and medial taxonomy to improve the quality of clinical trials in the field of critical care. DATA S...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e3181920ee8
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:To determine whether treatment with patient-controlled analgesia (PCA) alone or in combination with nonsteroidal anti-inflammatory drugs can prevent postoperative pulmonary complications after cardiac surgery, when compared with conventional nurse-controlled analgesia. DESIGN:Randomized controlled trial. SE...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-199910000-00025
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVE:Trauma induces a state of immunosuppression, which is responsible for the development of nosocomial infections. Hydrocortisone reduces the rate of pneumonia in patients with trauma. Because alterations of dendritic cells and natural killer cells play a central role in trauma-induced immunosuppression, we inve...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/CCM.0000000000000658
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVES:In this study, we evaluated the inflammatory response in patients with severe acute respiratory infection due to the Middle East respiratory syndrome and non-Middle East respiratory syndrome and assessed the presence of distinct inflammatory subphenotypes using latent class analysis. DESIGN:Prospective coho...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004724
更新日期:2021-02-01 00:00:00
abstract:OBJECTIVES:To establish Department of Veterans Affairs' intensive care unit (ICU) costs from a database and to use this information to validate the Russell equation, the most commonly used method of calculating ICU costs. To compare and trend Department of Veterans Affairs' and nationwide (USA) ICU and healthcare costs...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
abstract:OBJECTIVE:Intrahospital transport of critically ill patients is often necessary for optimal patient care. However, transport of intensive care unit (ICU) patients within the hospital has been associated with a high rate of potentially detrimental complications. This study was designed to determine the occurrence rate o...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199510000-00009
更新日期:1995-10-01 00:00:00
abstract:OBJECTIVE:To investigate, in restrictive patients, the influence of pressure ramp slope values on the efficacy of pressure support ventilation. DESIGN:Prospective study. SETTING:A university hospital medical intensive care unit. PATIENTS:Twelve intubated restrictive patients. INTERVENTIONS:Patients were randomly as...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-199904000-00023
更新日期:1999-04-01 00:00:00
abstract:OBJECTIVES:Sepsis, a life-threatening organ dysfunction caused by a dysregulated host response to infection, is a leading cause of death and disability among children worldwide. Identifying sepsis in pediatric patients is difficult and can lead to treatment delay. Our objective was to assess the host proteomic response...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004083
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVES:To determine whether excessive alcohol consumption increases the risk for intensive care unit (ICU)-acquired bacterial infection, especially ventilator-associated pneumonia (VAP), in nontrauma patients. DESIGN:Prospective observational cohort study. SETTING:A 21-bed polyvalent ICU in a university hospital....
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318174dd75
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVE:We investigated whether serum levels of neuron-specific enolase (NSE) and S-100beta protein could be used to evaluate cerebral injury and to predict outcome in severe sepsis and severe septic shock. DESIGN:Prospective study. SETTING:University hospital. PATIENTS AND MEASUREMENTS:In 170 consecutively enroll...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000217218.51381.49
更新日期:2006-07-01 00:00:00
abstract:OBJECTIVE:An increasing number of ICU patients survive and develop mental, cognitive, or physical impairments. Various interventions support recovery from this postintensive care syndrome. Physicians in charge of post-ICU patients need to know which interventions are effective. DATA SOURCES:Systematic literature searc...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0000000000000148
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Venous thromboembolic disease is among the most common causes of morbidity and mortality during pregnancy. The clinical evaluation alone is insufficient for the diagnosis of venous thromboembolic disease, and the normal pregnant state makes this evaluation even more challenging. DIAGNOSIS:Objective testing ...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.ccm.0000183157.15533.4c
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:To determine whether four stages of weaning (acute, prewean, wean, and outcome) could be identified by using clinical instruments designed to quantify severity of illness, patient stability, or weaning readiness. The instruments used were the Acute Physiology and Chronic Health Evaluation (APACHE III), the Th...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200007000-00013
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the occurrence of complications and patient deteriorations during the air and ground transportation of intubated pediatric patients, performed by a nonphysician-based team under the direction of an intensive care attending physician or fellow. DESIGN:Retrospective chart review. SETTING:A 600-bed...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199207000-00011
更新日期:1992-07-01 00:00:00
abstract:OBJECTIVE:End-of-life practices vary worldwide. The objective was to demonstrate that there is no clear-cut distinction between treatments administered to relieve pain and suffering and those intended to shorten the dying process. DESIGN:Secondary analysis of a prospective, observational study. SETTING:Thirty-seven i...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/01.CCM.0000295304.99946.58
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:To systematically investigate the effect of altering release time during airway pressure release ventilation in a neonatal animal model before and after oleic acid-induced acute lung injury. DESIGN:Prospective, nonrandomized, controlled study with repeated measures. SETTING:University research laboratory. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199403000-00020
更新日期:1994-03-01 00:00:00
abstract:OBJECTIVES:Previous studies in adults suggest that various types of physiologic stress appear to decrease phagocytic cell function. Adherence and chemotaxis of, and phagocytosis and bacterial killing by, neonatal neutrophils are altered compared with adult neutrophil function. Stresses encountered by the fetus and neon...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199312000-00022
更新日期:1993-12-01 00:00:00
abstract::Total parenteral nutrition (TPN) increases CO2 production (VCO2) in patients on intermittent positive-pressure ventilation who cannot match their CO2 excretion to the CO2 load, leading to an increase in PaCO2. We studied gas exchange and blood gas values in six patients with chronic respiratory failure, who were venti...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198507000-00005
更新日期:1985-07-01 00:00:00
abstract:BACKGROUND:Neurologic dysfunction, coma, and seizures are common in obstetric patients in the intensive care unit. OBJECTIVE:To review common neurologic disorders resulting in critical illness in pregnancy. REVIEW:Obstetric disorders causing coma and seizures include eclampsia, acute fatty liver of pregnancy, and amn...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.ccm.0000182790.35728.f7
更新日期:2005-10-01 00:00:00
abstract::Clinical impressions about the problem of defibrillation during states of acid-base imbalance and hypoxia have been influenced by studies involving the effect of these derangements on the ventricular fibrillation threshold. Based on body weight, energy requirements for defibrillation in normal dogs were compared to re...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197507000-00003
更新日期:1975-07-01 00:00:00