การเริ่มเคลื่อนไหวร่างกายโดยเร็วในผู้ป่วยที่ใช้เครื่องช่วยหายใจ: แนวทางสู่การปฏิบัติทางคลินิก

Mukkapon Punpop; Tarntana Supreeyatitikul; Tachit Jiravichitchai

Authors

Mukkapon Punpop Ramathibodi Hospital
Tarntana Supreeyatitikul Ramathibodi Hospital
Tachit Jiravichitchai Ramathibodi Hospital

Keywords:

early mobilization, mechanical ventilation, intensive care unit

Abstract

Introduction: Mechanically ventilated patients often experience prolonged immobilization, which can lead to short-and long-term complications such as muscle weakness, joint contractures, ventilator-associated pneumonia, and prolonged recovery. These conditions often contribute to longer hospital stays, reduced ability to perform activities of daily living, decreased functional independence, and reduced quality of life. Early mobilization is a key strategy to prevent complications and promote functional recovery in critically ill patients.

Objectives: This academic article aims to propose evidence-based nursing practices for promoting early mobilization in mechanically ventilated patients. It includes readiness assessment criteria, contraindications, nurse roles, and strategies for clinical implementation.

Key issues: Early mobilization should begin within 24 - 96 hours of ICU admission or as soon as the patient is stable. The readiness assessment criteria could be evaluated based on vital signs, level of consciousness, and respiratory status. Nurses play a critical role in evaluating readiness, preparing patients, performing and monitoring the mobilization activities, communicating with patients and families, and coordinating with multidisciplinary teams.

Conclusions: Daily progressive mobilization-from in-bed to out-of-bed mobilization should be performed for at least 10 - 15 minutes, tailored to the patient’s tolerance. This approach has been shown to reduce complications, enhance recovery, and significantly shorten the duration of mechanical ventilation and ICU stay.

Implications: This practice guideline could be applied to patients who meet readiness criteria and have no contraindications. Nurses should prioritize patient safety and implement early mobilization with caution. Collaboration with multidisciplinary teams is essential to ensure the effectiveness of early mobilization and promote optimal patient outcomes.

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