Related Experiment Video
Updated: Oct 3, 2026

Implementing In-bed Cycle Ergometry for Mechanically Ventilated Patients using the Rehabilitation Treatment Specification System
Published on: July 7, 2026
Nurse-led early mobilization and ICU-acquired weakness in mechanically ventilated adults: a retrospective
Haiyun Yang1, Aijuan Zhang1, Gaigai Nie1
1Department of Critical Care Medicine, Suzhou Wuzhong People's Hospital, Suzhou, Jiangsu, China.
Introduction:
ICU-acquired weakness (ICU-AW) is a frequent complication of critical illness, and real-world evidence on nurse-led early mobilization (EM) in Asian ICUs remains limited.
Methods:
We conducted a single-center, retrospective before-after cohort study of invasively ventilated adults admitted during usual-care (n = 153) and nurse-led EM (n = 164) periods. ICU-AW, defined as a Medical Research Council (MRC) sum score <48, was assessed among evaluable ICU survivors (n = 266); ICU death made volitional strength testing non-evaluable and was addressed in a death-or-ICU-AW composite sensitivity analysis. The primary model estimated the association between protocol implementation and ICU-AW after adjustment for baseline confounders; post-exposure care processes were examined separately.
Results:
ICU-AW occurred in 60/129 (46.5%) usual-care survivors and 40/137 (29.2%) nurse-led EM survivors (crude absolute risk difference 17.3 percentage points [95% CI 5.8-28.8] among evaluable survivors; crude OR 0.474, 95% CI 0.286-0.786). The baseline-adjusted OR was 0.436 (95% CI 0.248-0.766; P = 0.004). Morbidity-related secondary outcomes favored nurse-led EM, including lower delirium incidence (41.2% vs. 22.6%; OR 0.416), shorter ICU stay (median 11 vs. 8 days), and higher discharge Barthel Index (70 vs. 85). No statistically significant ICU mortality difference was detected (15.7% vs. 16.5%; OR 1.059, 95% CI 0.581-1.93), but the study was not powered to exclude clinically important mortality effects.
Discussion:
Nurse-led EM implementation was associated with lower odds of ICU-AW and improved morbidity outcomes. Because exposure was assigned by historical period, residual and secular confounding remain important limitations, and confirmation in a randomized or stepped-wedge implementation study is warranted.
Related Concept Videos
Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
Acute Respiratory Failure-I
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
Acute Respiratory Failure-III
Pneumonia III: Complications and Assessment
Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.