Team: A Prospective Multi-Centre Cohort Study Of Early Activity And Mobilisation In Icu

The extent to which patients are mobilised by physiotherapists in ANZ (Australia and New Zealand) ICU?s is not yet known. Aims: The overall purpose of the study is to gather data to inform the design of a pilot RCT of early mobility in ventilated ICU patients. Specifically we aim to: 1. Describe current mobility practice, including the incidence, duration and intensity of mobilisation in mechanically ventilated patients 2. Identify patient, site, and treatment related factors that are associated with successful mobilisation in mechanically ventilated patients. Methods: This was a prospective, observational, inception cohort study. The study was conducted in 13 ICUs in Australia and New Zealand and is currently recruiting 200 patients, with a maximum of 25 patients being recruited from any one site. Participants were eligible for inclusion if they are admitted to an ICU, invasively ventilated, and are expected to still require treatment in an ICU in two days? time. Patients were studied daily from time of enrolment until day 14 and at the time of ICU discharge. Mobilisation was measured using a purpose designed scale and scored from 1 (in bed) to 12 (walking). Barriers to mobility were recorded. Results: 40 patients on mechanical ventilation were enrolled into the study. On day one the highest level of activity according to the TEAM mobility scale was lying in bed (score 1, 100 ). Most patients (95 ) were not mobilised within the first 72 hours of mechanical ventilation. Patients receiving mechanical ventilation were rarely mobilised out of bed (95 ). In 95 of participant?s the main barrier to early mobilisation was sedation. Other barriers included cardiac instability and written rest in bed orders. Patients who were mobilised out of bed after 72 hours (20 ) were mobilised by both a physiotherapist and a nurse, although mobilization practice (time, equipment and staff) varied between sites. Conclusion: Although physiotherapists are commonly employed to work in intensive care units in Australia and New Zealand, early mobilisation practice differs between intensive care units. Most patients are not mobilised out of bed while receiving mechanical ventilation. The main barrier to mobilisation was sedation.