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Mobilization in severe sepsis: an integrative review
Journal of Hospital Medicine
|November 14, 2014
Summary
Early mobilization, or physical therapy (PT), shows limited evidence for improving severe sepsis outcomes in non-intensive care unit (ICU) settings. More research is needed to understand PT
Area of Science:
- Critical Care Medicine
- Rehabilitation Medicine
- Infectious Diseases
Background:
- Severe sepsis significantly contributes to long-term patient morbidity in the United States.
- A substantial portion of severe sepsis cases are managed outside of intensive care units (ICUs), highlighting relevance to hospitalist practice.
- Physical therapy (PT) is recognized for its benefits in various medical conditions, but its specific role in severe sepsis management remains unclear.
Purpose of the Study:
- To review existing literature on the efficacy of early mobilization and physical therapy (PT) for severe sepsis patients treated in non-ICU settings.
- To explore the pathophysiology of functional decline in severe sepsis and the rationale for PT interventions.
- To identify research gaps concerning early mobilization's impact on severe sepsis outcomes.
Main Methods:
- A comprehensive literature search was conducted across multiple databases using keywords related to length of stay, mortality, costs, mobilization, and PT.
- Two independent reviewers assessed study eligibility.
- A secondary review included studies on infectious pathologies with PT or sepsis patients within the ICU.
Main Results:
- No primary studies were found specifically investigating the impact of mobilization on severe sepsis outcomes in non-ICU settings.
- One retrospective study suggested potential benefits of therapy for sepsis patients in the ICU.
- A single study in a non-ICU setting reported outcomes after early mobilization intervention in patients with bacterial pneumonia.
Conclusions:
- There is a significant lack of primary research on the efficacy of early mobilization for severe sepsis patients in non-ICU settings.
- Hospitalists frequently manage severe sepsis patients, indicating a critical opportunity for future research in this area.
- Further investigation is warranted to establish the role and benefits of physical therapy and early mobilization in severe sepsis care outside the ICU.
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