Feasibility, Safety and Outcomes of Early Mobilization in the ICU Following Lung Transplantation: A Scoping Review

Lung transplantation (LTx) is performed in approximately 4500 patients worldwide each year. Postoperatively, patients are at high risk of muscle catabolism due to Intensive Care Unit (ICU)-acquired weakness, potentially compromising functional recovery. While post-LTx rehabilitation is usually initiated after hospital discharge, the feasibility and safety of early mobilization during the ICU stay remain unclear. This scoping review aimed to synthesize available evidence on the feasibility, safety, and outcomes of early mobilization initiated in the ICU following LTx.

We conducted a scoping review with comprehensive searches in MEDLINE (via PubMed), Embase, PEDro, Web of Science, CINAHL, Scopus, Cochrane CENTRAL, and PROSPERO. Study selection, data extraction, and analysis were performed independently by two reviewers.

The search identified 3219 records, of which 32 sources met inclusion criteria, including 17 original studies, three conference abstracts, four registered protocols, and eight narrative reviews. Despite marked heterogeneity in study designs, interventions, and outcomes, early mobilization was consistently reported as feasible and safe, with initiation possible within the first 24 h of ICU stay. Interventions were generally multimodal, progressive, and individualized. Adverse events were infrequently reported.

Early mobilization during the ICU stay following LTx appears feasible and safe, although the evidence is limited by the small number of studies and the predominance of low-level designs. Based on the available literature, we propose a preliminary mobilization framework tailored to this population. Further high-quality studies are required to confirm these findings and to evaluate clinical benefits.

Open Science Framework https://osf.io/nhr3e.