Early Ambulation: A Literature Review Study

It is commonly known that patients, particularly the older patient population, decondition rapidly while admitted inpatient to the hospital. This is a result of multiple factors including lack of mobility and disease processes. In the ICU, patients are especially at risk due to the critical nature of their adverse health event and the stress it causes their body. When that patient is intubated and sedated, the toll their hospital stay has on their body worsens.
While today many patients who are intubated are only lightly sedated at most, they usually spend days on end in bed with maybe some in bed physical therapy that is not nearly enough to sustain strength and conditioning. Many hospitals around the country in response to this have begun early ambulation while a patient is vented. This concept is new and
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Castro-Avila et al. (2015) noted in their study a lack of improvement to functional status, muscle strength, quality of life or healthcare utilization outcomes, to patients who receive rehabilitation during ICU stay (pg. 21), meaning the results for inconclusive as to the actual benefits of early ambulation. While Stiller, strongly recommended the implementation of early mobilization as the reverse, bedrest, had a long history of disadvantageous effects to mechanically ventilated patients. Li et al. did not have firm conclusions, however, did suggest beginning early rehabilitation interventions, that could continue on through discharge to inpatient floors. Overall, the systematic reviews displayed positive outcomes from early ambulation, although, the evidence was weak/moderate and more research needs to be completed with more defined and consistent methods and measures. More research is needed to answer the PICO question: Does early ambulation while on the ventilator help reduce the time spent in the hospital and/or recovering for patients who have respiratory

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