Guideline on positioning and early mobilisation in the critically ill by an expert panel.

Autor: Schaller SJ; Department of Anaesthesiology and Intensive Care Medicine (CCM/CVK), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany. stefan.schaller@charite.de., Scheffenbichler FT; Department of Anaesthesiology and Intensive Care Medicine, Ulm University, Ulm, Germany., Bein T; Universität Regensburg, Regensburg, Germany., Blobner M; Department of Anaesthesiology and Intensive Care Medicine, Ulm University, Ulm, Germany.; Department of Anaesthesiology and Intensive Care Medicine, School of Medicine and Health, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany., Grunow JJ; Department of Anaesthesiology and Intensive Care Medicine (CCM/CVK), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany., Hamsen U; Ruhr University Bochum, Bochum, Germany.; Department of General and Trauma Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany., Hermes C; Hochschule für Angewandte Wissenschaften Hamburg (HAW Hamburg), Hamburg, Germany.; Akkon-Hochschule für Humanwissenschaften, Berlin, Germany., Kaltwasser A; Academy of the District Hospitals Reutlingen, Kreiskliniken Reutlingen, Reutlingen, Germany., Lewald H; Department of Anaesthesiology and Intensive Care Medicine, School of Medicine and Health, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany., Nydahl P; University Hospital of Schleswig-Holstein, Kiel, Germany.; Institute of Nursing Science and Development, Paracelsus Medical University, Salzburg, Austria., Reißhauer A; Department of Rehabilitation Medicine, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany., Renzewitz L; Department of Physiotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.; Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University of Duisburg-Essen, Essen, Germany., Siemon K; Department of Pneumology, Fachkrankenhaus Kloster Grafschaft, Schmallenberg, Germany., Staudinger T; Department of Medicine I, Medical University of Vienna, Vienna, Austria., Ullrich R; Department of Anaesthesia, General Intensive Care and Pain Medicine, Medical University of Vienna, Vienna, Austria.; Department of Anaesthesiology and Intensive Care Medicine, AUVA Trauma Center Vienna, Vienna, Austria., Weber-Carstens S; Department of Anaesthesiology and Intensive Care Medicine (CCM/CVK), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany., Wrigge H; Department of Anaesthesiology, Intensive Care and Emergency Medicine, Pain Therapy, Bergmannstrost Hospital, Halle, Germany.; Medical Faculty, Martin-Luther University Halle-Wittenberg, Halle, Germany., Zergiebel D; Münster University Hospital (UKM), Münster, Germany., Coldewey SM; Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany. sina.coldewey@med.uni-jena.de.; Septomics Research Center, Jena University Hospital, Jena, Germany. sina.coldewey@med.uni-jena.de.
Jazyk: angličtina
Zdroj: Intensive care medicine [Intensive Care Med] 2024 Aug; Vol. 50 (8), pp. 1211-1227. Date of Electronic Publication: 2024 Jul 29.
DOI: 10.1007/s00134-024-07532-2
Abstrakt: A scientific panel was created consisting of 23 interdisciplinary and interprofessional experts in intensive care medicine, physiotherapy, nursing care, surgery, rehabilitative medicine, and pneumology delegated from scientific societies together with a patient representative and a delegate from the Association of the Scientific Medical Societies who advised methodological implementation. The guideline was created according to the German Association of the Scientific Medical Societies (AWMF), based on The Appraisal of Guidelines for Research and Evaluation (AGREE) II. The topics of (early) mobilisation, neuromuscular electrical stimulation, assist devices for mobilisation, and positioning, including prone positioning, were identified as areas to be addressed and assigned to specialist expert groups, taking conflicts of interest into account. The panel formulated PICO questions (addressing the population, intervention, comparison or control group as well as the resulting outcomes), conducted a systematic literature review with abstract screening and full-text analysis and created summary tables. This was followed by grading the evidence according to the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence and a risk of bias assessment. The recommendations were finalized according to GRADE and voted using an online Delphi process followed by a final hybrid consensus conference. The German long version of the guideline was approved by the professional associations. For this English version an update of the systematic review was conducted until April 2024 and recommendation adapted based on new evidence in systematic reviews and randomized controlled trials. In total, 46 recommendations were developed and research gaps addressed.
(© 2024. The Author(s).)
Databáze: MEDLINE
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