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Early mobilisation and prevention of Intensive Care Unit Acquired Weakness (ICU-AW): a narrative review of the literature

Authors

Sofia Sancisi
scenario@aniarti.it
Infermiere, Medicina Interna, Ospedale “G.Marconi”, Cesenatico (FC). AUSL della Romagna. Italia, .
Alessandro Monesi
Infermiere, Terapia Intensiva e Rianimazione, Ospedale Maggiore, AUSL di Bologna. Bologna. Italia, .
Guglielmo Imbrìaco
Infermiere, Centrale Operativa 118 Emilia Est, Emergenza Territoriale, Elisoccorso, Ospedale Maggiore, AUSL di Bologna. Bologna. Italia, .

Introduction: Intensive Care Unit Acquired Weakness (ICUAW) is a frequent complication that can occur in a high percentage of patients admitted to the intensive care unit, characterised by fatigue and neuromuscular weakness, and can persist even years after discharge. Early mobilisation interventions on critically ill patients, including during mechanical ventilation, have shown positive and encouraging results in preventing ICUAW.
Aim: To describe the efficacy, safety and feasibility of early mobilisation activities compared to standard mobilisation activities in the prevention of (ICUAW).
Materials and methods: Literature review of the major biomedical databases (Pubmed, Cochrane library, UpToDate, CINAHL - Cumulative Index to Nursing & Allied Health Database), using different search modes, in a 15-year retroactive mode. The search strategy was performed by combining the keywords "ICUAW", "Early Mobilization", "Adult", "Intensive Care Unit", "Critical Illness", defining criteria for inclusion and exclusion of studies.
Results: The initial search initially yielded 237 studies; after eliminating duplicates, applying search filters and following reading of title, abstract and full text, a total of 16 studies were considered: 5 systematic reviews, 4 randomised controlled trials, 6 reviews and 1 clinical trial.
Conclusions: Early mobilisation in the ICU was found to be a safe and feasible practice and the number of adverse events was extremely limited; it also increased the functional abilities of the patients, both during the hospital stay and at discharge, who were able to perform activities such as sitting at the foot of the bed, moving to an armchair to ambulation to a greater degree. The results regarding length of stay in intensive care and muscle strength were mixed. Further studies, with uniform outcome assessment criteria, would be needed to further investigate the effectiveness of these interventions.

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How to Cite

Sancisi, S., Monesi, A., & Imbrìaco, G. (2022). Early mobilisation and prevention of Intensive Care Unit Acquired Weakness (ICU-AW): a narrative review of the literature. Scenario® - Il Nursing Nella Sopravvivenza, 38(4), 29–42. https://doi.org/10.4081/scenario.2021.501
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