Mobilization of Mechanically Ventilated Patients in Switzerland.
PURPOSE
Growing evidence suggests that early mobilization benefits intensive care unit (ICU) patients. However, national practices and the culture of individual ICUs influence mobilization activities.


MATERIALS AND METHODS
In a 1-day, Swiss point prevalence study conducted in 35 ICUs (representing 45% of all ICUs), the highest level of mobilization for mechanically ventilated patients was characterized using the validated ICU Mobility Scale, along with data collection for potential safety events and mobilization barriers.


RESULTS
Among 161 mechanically ventilated patients, a total of 33% (n = 53) had active mobilization, with walking achieved by only 2% (n = 4). More severe organ failure was associated with lower mobilization (respiratory Sequential Organ Failure Assessment score: P = .037, cardiac: P = .008, neurology: P < .001). Barriers to mobilization were reported in 71% (n = 115), with deep sedation significantly higher among patients receiving passive versus active mobilization (14% vs 0%, P = .005). Potential safety events occurred in 20% (n = 33) of patients without significant differences between passive and active mobilization. Availability of physiotherapists and appropriate equipment were not reported barriers.


CONCLUSION
Mobilization during mechanical ventilation occurred infrequently with greater organ failure associated with lower mobilization. Addressing the identified modifiable barriers via structured efforts to achieve multidisciplinary culture change is essential to decrease the common use of bed rest in Swiss ICUs.
['Sibilla|Alberto|A|https://orcid.org/0000-0002-8500-9746', 'Nydahl|Peter|P|https://orcid.org/0000-0002-5178-0364', 'Greco|Nicola|N|', 'Mungo|Giuseppe|G|', 'Ott|Natalie|N|', 'Unger|Ines|I|', 'Rezek|Spencer|S|', 'Gemperle|Sarah|S|', 'Needham|Dale M|DM|', 'Kudchadkar|Sapna R|SR|']
D000328:Adult D000368:Aged D004434:Early Ambulation D005260:Female D006801:Humans D007362:Intensive Care Units D008297:Male D008875:Middle Aged D051346:Mobility Limitation D063305:Organ Dysfunction Scores D012121:Respiration, Artificial D013557:Switzerland
mechanical ventilation early mobilization intensive care unit critical care physical therapy rehabilitation