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Highly Accessed Review

Bench-to-bedside review: Mobilizing patients in the intensive care unit – from pathophysiology to clinical trials

Alex D Truong1, Eddy Fan1, Roy G Brower1 and Dale M Needham12*

Author Affiliations

1 Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA

2 Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA

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Critical Care 2009, 13:216  doi:10.1186/cc7885


See related commentary by Puthucheary and Hart, http://ccforum.com/content/13/4/167

Published: 13 July 2009

Abstract

As the mortality from critical illness has improved in recent years, there has been increasing focus on patient outcomes after hospital discharge. Neuromuscular weakness acquired in the intensive care unit (ICU) is common, persistent, and often severe. Immobility due to prolonged bed rest in the ICU may play an important role in the development of ICU-acquired weakness. Studies in other patient populations have demonstrated that moderate exercise is beneficial in altering the inflammatory milieu associated with immobility, and in improving muscle strength and physical function. Recent studies have demonstrated that early mobility in the ICU is safe and feasible, with a potential reduction in short-term physical impairment. However, early mobility requires a significant change in ICU practice, with reductions in heavy sedation and bed rest. Further research is required to determine whether early mobility in the ICU can improve patients' short-term and long-term outcomes.