Table 3. The Cancellation Criteria for Early Mobilization and Active Exercise in the Early Phase in the ICU proposed by the expert consensus of the Japanese Society of Intensive Care Medicine14).
Category | Elements index | Value of decision criteria or condition | Remarks |
General Nervous system |
Reaction Expression Consciousness Agitation Voluntary movement of extremities Posture adjustment |
Occurrence of obvious poor reactions Agony expression, the occurrence of pallor or cyanosis The occurrence of mild or more impaired consciousness The occurrence of dangerous behavior The occurrence of limb weakness Rapid increase in assistance Posture cannot be held, fall |
Drowsiness, stupor in response to call |
Subjective symptoms | Dyspnea Fatigue |
Complaint of sudden dyspnea Appearance of forced breathing Unbearable fatigue Patient wants to stop |
Pneumothorax, PTE Modified Borg scale 5–8 |
Respiratory system | Respiratory rate SpO2 Respiration pattern Ventilator |
<5 per min or >40 per min <88% Appearance of sudden expiratory or inspiratory effort breathing Desynchronization, bucking |
Except for transient symptoms assess with the findings of airway obstruction, for example by auscultation |
Circulatory system | Heart rate Electrocardiograms Blood pressure |
Decreased heart rate or bradycardia after starting
exercise <40 bpm or >130 bpm New rhythm disorders Suspected myocardial ischemia Systolic blood pressure <65 mmHg or >180 mmHg 20% decrease of systolic or diastolic blood pressure Mean atrial pressure >110 mmHg |
Except for transient symptoms |
Devices | Artificial airway Nasogastric tube, central venous catheter Chest drain, wound drain, bladder catheter |
Risks or occurrences of accidental removal | |
Others | Patient refusal Action for suspension Suggestion of active bleeding Surgical wound condition |
Appearance of drain waste Risk of wound opening |