Effect of early mobilization on the physical function of patients in intensive care unit: a Meta-analysis
10.3760/cma.j.issn.2095-4352.2019.04.017
- VernacularTitle:早期活动对ICU患者身体功能状态影响的Meta分析
- Author:
Yan HU
1
;
Xiaoying HU
;
Jia XIAO
;
Dongying LI
Author Information
1. 南昌大学第二附属医院重症医学科
- Keywords:
Early mobilization;
Intensive care unit;
State of body function;
Meta-analysis
- From:
Chinese Critical Care Medicine
2019;31(4):458-463
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically evaluate the effect of early mobilization on the physical function of patients in intensive care unit (ICU). Methods The randomized controlled trials (RCT) about early intervention in ICU patients were retrieved from the Cochrane Library, PubMed, Wed of Science, Medline, CBM, CNKI, VIP, and Wanfang database, all of which were published literatures from the establishment to October 2018. Early activities were carried out in the intervention group, while only routine nursing was carried out in the control group. Outcome measures included the medical research council score (MRC-Score), physical function ICU test (PFIT), independent walking ability, score of quality of life health survey short form (SF-36), incidence of ICU-acquired weakness (ICU-AW) and hospital mortality. Two researchers independently screened the literature, evaluated the quality of the literature and extracted the data. After literature selection, literature quality evaluation and date extraction was performed, and RevMan 5.3 software was used for Meta-analysis. The publication bias was analyzed by funnel plot. Results A total of 13 literatures were included, 10 in English and 3 in Chinese; of the 1 347 patients, 695 in intervention group and 652 in control group. Compared with the control group, the MRC-Score was increased in intervention group [mean difference (MD) = 4.74, 95% confidence interval (95%CI) = 2.30-7.19, P = 0.000 1], independent walking ability was improved [odds ratio (OR) = 2.04, 95%CI =1.39-2.99, P = 0.000 3], the incidence of ICU-AW was decreased (OR = 0.22, 95%CI = 0.14-0.35, P < 0.000 01), and there was no significant difference in PFIT (MD = -0.19, 95%CI = -0.69-0.31, P = 0.46), physical health (PCS) after 6 months (MD = -1.39, 95%CI = -4.18-1.39, P = 0.33) and inpatient mortality (OR = 0.77, 95%CI = 0.53-1.12, P = 0.17) between two groups. It was shown by funnel plot that the publication bias of each literature was relatively small in terms of MRC-Score, PFIT, independent walking ability and SF-36. Conclusion Early mobilization are beneficial for the physical function recovery of ICU patients, which can improve the muscle strength, improve the ability of patients to walk independently, reduce the occurrence of ICU-AW, and do not increase the mortality rate in hospital.
