[Algorithms for early mobilization in intensive care units].

Area of Science:

• Intensive Care Medicine
• Rehabilitation Therapy
• Patient Mobility

Background:

• Immobility in intensive care units (ICU) leads to significant physical and cognitive decline.
• Rehabilitation bundles, incorporating early mobilization, have emerged to combat these effects.
• German guidelines advocate for the development of ICU-specific mobilization protocols.

Purpose of the Study:

• To provide guidance for developing best practice early mobilization protocols in intensive care units.
• To outline key components for effective ICU-specific rehabilitation strategies.
• To support healthcare professionals in implementing evidence-based mobilization practices.

Main Methods:

• This narrative review synthesizes current recommendations and best practices for ICU early mobilization.
• It focuses on the development of ICU-specific protocols.
• Key elements such as screening, safety criteria, and documentation tools are discussed.

Main Results:

• Recommends implementing early mobilization as a bundle including screening for awareness, pain, anxiety, stress, delirium, and family presence.
• Advocates for an interprofessional development of a traffic-light system for inclusion/exclusion criteria.
• Suggests using checklists for risk assessment, the ICU Mobility Scale for targeting and documentation, and the Borg Scale for subjective evaluation, alongside safety criteria for hemodynamic and respiratory changes.

Conclusions:

• Systematic documentation and evaluation of mobilization levels, barriers, and safety events are essential.
• Developing and implementing ICU-specific early mobilization protocols is vital for improving patient outcomes.
• A comprehensive approach integrating various assessment tools and interprofessional collaboration enhances rehabilitation effectiveness.