EARLY MOBILIZATION IN THE INTENSIVE CARE UNIT: AN INTEGRATIVE REVIEW ON SAFETY CRITERIA, FUNCTIONAL PROGRESSION, AND SUPPORT FOR CLINICAL DECISION-MAKING

Abstract

Introduction: The prolonged immobility in critical ill patients in Intensive Care Units (ICU) are directly associated with the development of the unit intensive care acquired weakness (ICU-AW), resulting in functionality reductiveness, prolonged time in mechanical ventilation and time of stay. This way, the early mobilization has been described as an important strategy to reduce the deleterious effects of the prolonged immobilization and to favor the functional recovery of these patients. Methods: The present study was realized in literature review, with analysis of 15 studies taken from PubMed (n = 8), PEDro (n = 3), Scielo (n = 3) e Cochrane (n = 1), with the objective of analyzing intervention protocols, safe criterias, time of beginning, mobilization progress and functional outcomes. Results: The studies found indicate that early mobilization can help to reduce the ICU-AW, especially when replicated in a safe, progressive and individualized way. The literature suggests that mobilization in the first 24 to 72 hours can be better to some outcomes, provided that are respected the safe criterias, clinical stability and continuous monitorization. Effects to mortality, quality of life and long term outcomes are still inconsistent. Conclusion: It's concluded that early mobilization is a promising and relevant strategy in the care of critical ill patients, mainly for your functional benefits. However, the application needs to be oriented by safe criterias, individualized assessment and correct progression.