Out-of-bed mobilization of patients undergoing mechanical ventilation with orotracheal tubes: A survey study

Abstract

Purpose: The aim of this study is to clarify intensive care unit (ICU)-level factors facilitating out-of-bed mobilization defined as a range of activities from sitting on edge of bed up to walking in mechanically ventilated patients with orotracheal tubes.

Materials and methods: We conducted a survey of all intensive care units (ICUs) certified by the Japanese Society of Intensive Care Medicine (excluding pediatric ICUs) as training facilities for intensivists.

Results: We surveyed 294 ICUs, with a response rate of 57% (n = 168). A dedicated physical and/or occupational and/or speech therapy team was present in 34 ICUs (20%). In 86 ICUs (51%), mechanically ventilated patients with orotracheal tubes also routinely underwent out-of-bed mobilization, and 38 ICUs (23%) used a written mobilization protocol. Factors independently associated with routine out-of-bed mobilization were the presence of a dedicated therapist in the ICU (odds ratio [OR], 6.83; 95% confidence interval [CI], 2.17-21.50; p = 0.001) and a high intensity physician staffing (OR, 2.37; 95% CI, 1.03-5.51; p = 0.043).

Conclusions: Based on impression of professionals, the presence of dedicated therapist in the ICU, and the high intensity physician staffing are significantly associated with an increased rate of out-of-bed mobilization for mechanically ventilated patients with orotracheal tubes.

Keywords: Critical care; Mechanical ventilation; Out-of-bed mobilization; Physical therapy; Progressive mobility.