Table 1.
Summary of included studies and study participants
| Study | Country, timeframe | Population | Group | No. of participants | Female n (%) | Age in years mean (SD)/median (IQR) | APACHE II score mean (SD)/median (IQR) | Patient admission diagnoses |
|---|---|---|---|---|---|---|---|---|
| (i) Systematic early vs. late mobilization | ||||||||
| Schweickert et al. [23] | USA 2005–2007 | Adult ICU patients, mechanically ventilated < 72 h, independent at baseline | Comparator | 55 | 23 (41.8) | 54.4 (46.5–66.4) | 19.0 (13.3–23.0) | Lung injury (56%), COPD exacerbation (10%), acute exacerbation of asthma (9%), sepsis (15%), hemorrhage (3%), malignancy (3%), other (5%) |
| Intervention | 49 | 29 (59.2) | 57.7 (36.3–69.1) | 20.0 (15.8–24.0) | ||||
| Morris et al. [32] | USA 2009–2014 | Adult ICU patients, acute respiratory failure requiring mechanical ventilation | Comparator | 150 | 82 (54.7) | 58 (14) | 75.0 (27.0)b | Acute respiratory failure (98%), coma (2%) |
| Intervention | 150 | 84 (56.0) | 55 (17) | 76.0 (26.0)b | ||||
| (ii) Systematic early vs. standard early mobilization | ||||||||
| Dantas et al. [24] | Brazil 2009–2011 | Adult ICU patients on mechanical ventilation, adequate cardiovascular and respiratory reserve | Comparator | 14 | 10 (71.4) | 50.4 (20.5) | 21.1 (7.2) | Acute respiratory failure (46%), pneumonia (14%), cardiomyopathy (0%), collagenosis (4%), postoperative after thoraco-abdominal surgery (11%), acute myocardial infarction (7%), leptospirosis (4%), acute renal insufficiency (4%), pulmonary tuberculosis (7%), neoplasms (4%) |
| Intervention | 14 | 7 (50.0) | 59.1 (15.2) | 23.7 (8.5) | ||||
| Denehy et al. [25] | Australia 2007–2009 | Adult ICU patients, ICU length of stay ≥ 5 days | Comparator | 76 | 31 (40.8) | 60.1 (15.8) | 20.7 (7.7) | Pneumonia (23%), cardiac (15%), cardiac arrest (7%), cardiac surgery (30%), other surgery (21%), liver disease/transplant (14%), sepsis (11%), renal (5%), other (7%) |
| Intervention | 74 | 24 (32.4) | 61.4 (15.9) | 19.0 (6.0) | ||||
| Brummel et al. [26]a | USA 2011–2012 | Adult ICU patients, respiratory failure and/or septic, cardiogenic or hemorrhagic shock, critically ill for < 72 h | Comparator | 22 | 14 (63.6) | 60 (51–69) | 27.0 (17.5–31.0) | Sepsis/ARDS/pneumonia (60%), abdominal surgery (15%), other surgery (3%), airway protection (9%), cirrhosis/GI bleeding (5%), CHF/arrhythmia/cardiogenic shock (2%), other (6%) |
| Intervention (1) | 22 | 9 (40.9) | 62 (48–67) | 21.5 (20.0–28.8) | ||||
| Intervention (2) | 43 | 15 (34.9) | 62 (54–69) | 25.0 (19.5–29.5) | ||||
| Dong et al. [27] | China 2010–2012 | Adult ICU patients, mechanically ventilated between 48–72 h with expected ventilation of ≥ 1 week, clear consciousness, cardiovascular and respiratory stability | Comparator | 30 | 10 (33.3) | 55.5 (16.2) | 16.0 (4.1) | Abdominal infections (18%), ARDS (32%), sepsis (7%), severe acute pancreatitis (15%), pneumonia (23%), COPD exacerbation (5%) |
| Intervention | 30 | 9 (30.0) | 55.3 (16.1) | 15.0 (4.2) | ||||
| Kayambu et al. [28] | Australia 2010–2012 | Adult ICU patients, mechanically ventilated ≥ 48 h, diagnosis of sepsis or septic shock | Comparator | 24 | 10 (41.7) | 65.5 (37–85) | 27.0 (6.8) | Sepsis (100%) |
| Intervention | 26 | 8 (30.8) | 62.5 (30–83) | 28.0 (7.6) | ||||
| Dong et al. [29] | China 2012–2015 | Adult patients, prolonged mechanical ventilation > 72 h, eligible for coronary artery bypass surgery | Comparator | 53 | 31 (58.5) | 60.2 (15.1) | 17.2 (4.3) | Coronary artery bypass surgery (100%) |
| Intervention | 53 | 33 (62.3) | 62.6 (12.8) | 16.3 (4.2) | ||||
| Hodgson et al. [31] | Australia/New Zealand 2013–2014 | Adult ICU patients, mechanically ventilated within 72 h of ICU admission | Comparator | 21 | 12 (57.1) | 53 (15) | 15.9 (6.9) | N/A |
| Intervention | 29 | 8 (25.9) | 64 (12) | 19.8 (9.8) | ||||
| Schaller et al. [33] | USA/Germany 2011–2015 | Adult surgical ICU patients, mechanically ventilated for less than 48 h and for at least further 24 h, functionally independent at baseline | Comparator | 96 | 35 (36.5) | 64 (45–76) | 17 (11–22) | Visceral surgery (27%), vascular surgery (17%), ENT and ophthalmological surgery (10%), transplant surgery (4%), neurosurgery (3%), orthopedic surgery (3%), thoracic surgery (3%), gynecological surgery (2%), urological surgery (1%), plastic surgery (1%), medical or neurological diagnosis (6%), trauma (26%) |
| Intervention | 104 | 39 (37.5) | 66 (48–73) | 16 (12–22) | ||||
| Eggmann et al. [34] | Switzerland 2012–2016 | Adult ICU patients, expected to stay on mechanical ventilation for at least 72 h, independent before critical illness | Comparator | 57 | 16 (28.1) | 63 (15) | 23.0 (7.0) | Cardiac surgery (18%), neurology/neurosurgery (8%), other surgery (12%), gastroenterology (12%), trauma (4%), respiratory insufficiency (22%), hemodynamic insufficiency (23%), other (2%) |
| Intervention | 58 | 22 (37.9) | 65 (15) | 22.0 (8.0) | ||||
| (iii) Systematic early vs. no mobilization | ||||||||
| Fischer et al. [30] | Austria 2011–2012 | Patients with cardiothoracic surgery, anticipated ICU stay of ≥ 48 h | Comparator | 27 | 7 (25.9) | 69.7 (13.1) | N/A | Cardiothoracic surgery (100%) |
| Intervention | 27 | 9 (33.3) | 63.3 (15.5) | N/A | ||||
APACHE Acute Physiologic Assessment and Chronic Health Evaluation, ARDS acute respiratory distress syndrome, COPD chronic obstructive pulmonary disease, ICU intensive care unit, IQR interquartile range, N/A not available, SD standard deviation
aThree-arm trial
bAPACHE III score