Early Mobility Interventions in the Intensive Care Units Improve Patient Outcomes, claims research

A recent study published in the American Journal of Critical Care reveals that early mobility interventions in intensive care units (ICUs) significantly improve patient outcomes, though the optimal "dose" of mobility remains uncertain. The outcomes of this comprehensive research highlights the importance of out-of-bed activities for critically ill adults but points to variations in implementation across different ICU settings.

The primary goal of the study was to examine the relationship between the daily dose of out-of-bed mobility and patient outcomes in various ICUs. This retrospective cohort analysis utilized the electronic health records from seven adult ICUs within the hospital. They employed multivariable linear regression to assess the impact of out-of-bed events per mobility-eligible day on key outcomes such as the duration of mechanical ventilation, length of ICU stays and overall hospital stays.

The study included data from a total of 8609 adults hospitalized in ICUs from 2015 to 2018. The findings revealed that patients were mobilized out of bed on 46.5% of ICU days and were eligible for mobility interventions on a median of 2.0 (IQR: 1–3) out of 2.7 (IQR: 2–9) ICU days. The median number of out-of-bed events per mobility-eligible day was 0.5 (IQR: 0–1.2) across all patients.

Also, the study found that for every additional out-of-bed event per mobility-eligible day before extubation, the duration of mechanical ventilation decreased by 10% (adjusted coefficient [95% CI], −0.10 [−0.18 to −0.01]). While the increase in daily mobility extended ICU stays by 4% (adjusted coefficient [95% CI], 0.04 [0.03–0.06]), it reduced the overall hospital stays by 5% (adjusted coefficient [95% CI], −0.05 [−0.07 to −0.03]).

The research illuminated a dose-response relationship between daily mobility and improved the patient outcomes in reducing the length of mechanical ventilation and hospital stays. However, the effects were varied among different ICU subpopulations which indicates that a one-size-fits-all approach may not be applicable. This variability suggests that while early mobility is beneficial, tailored approaches based on specific ICU environments and patient needs are necessary for optimal results. The outcomes of this study indicates that increasing daily out-of-bed mobility can significantly improve outcomes for critically ill patients. And still, further research is imperative to determine the optimal mobility dose and to understand the differing impacts across various ICU settings. 

Source:

Fazio, S. A., Cortés-Puch, I., Stocking, J. C., Doroy, A. L., Black, H., Liu, A., Taylor, S. L., & Adams, J. Y. (2024). Early Mobility Index and Patient Outcomes: A Retrospective Study in Multiple Intensive Care Units. In American Journal of Critical Care (Vol. 33, Issue 3, pp. 171–179). AACN Publishing. https://doi.org/10.4037/ajcc2024747