ICU sedation, delirium & recovery
Structured Mobilization for Critically Ill Patients: A Pragmatic Cluster-randomized Trial
Primary resultResult — go to the resultEstimated mean difference 0.16 95% CI −0.31 to 0.63Authors' conclusion
A low-cost, multifaceted mobilization intervention did not improve overall mobility but improved patients' odds of standing and was safe.
Study context
- Population
- Patients mechanically ventilated for ⩾48 hours who were ambulatory before admission, 12 ICUsprimary sample
- Participants
- 1,069 vs 848
- Comparison
- Multifaceted mobilization intervention vs usual care
- Interventionn = 1,069
- Usual caren = 848reference
- Primary endpoint
- Maximal Intensive Care Mobility Scale (range, 0-10) score within 48 hours before ICU discharge
Methodological detailsstepped-wedge, pragmatic, multicentre (12 ICUs), Enrolment March 4, 2019 through March 15, 2020
- Stepped-wedge
- Pragmatic
- Multicentre (12 ICUs)
- Enrolment March 4, 2019 through March 15, 2020
Primary result
As reported in the abstract
Estimated mean difference
0.16
95% CI −0.31 to 0.63
P = 0.51
Intervention vs Usual care
estimated mean difference 0.16 (95% CI −0.31 to 0.63); P = 0.51
Secondary outcomes
| Outcome | Intervention | Usual care | OR (95% CI) | P value | |
|---|---|---|---|---|---|
| Ability to stand before ICU discharge (prespecified secondary outcome) | 37.2% | 30.7% | 1.48 (1.02–2.15) | P = 0.04 | |
| 0.512Odds ratio (log scale) |
Secondary sample (all patients with ICU stays ⩾48 h)
- Similar results observed among the 7,115 patients in the secondary sample
Mediation of effect on standing
- % of days with physical therapy mediated the intervention effect on standing
- 90.1%
ICU mortality
- ICU mortality similar between groups (all P > 0.3)
- 31.5% vs. 29.0%
Safety
Falls
- Falls similar between groups (all P > 0.3)
- 0.7% vs. 0.4%
Unplanned extubations
- Unplanned extubations similar between groups (all P > 0.3)
- 2.0% vs. 1.8%
Original publication
Structured Mobilization for Critically Ill Patients: A Pragmatic Cluster-randomized Trial. Am J Respir Crit Care Med. Published 1 July 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →