To mobilise or not to mobilise: is that the right question?

摘要: Muscle atrophy commences early, within hours of commencement of invasive mechanical ventilation [1]. Therefore, patients who receive prolonged mechanical ventilation are at high risk of muscle atrophy, severe weakness, long-term disability, and increased mortality [2–4]. To mitigate these risks, early mobilisation has been recommended in at least seven international guidelines [5]. It is a management strategy that has had widespread support from clinicians.Early mobilisation will purportedly reduce duration of mechanical ventilation and delirium and improve functional recovery, although the evidence from individual trials has been inconsistent [6–9]. The evidence for the international guidelines has been pooled from pilot studies, phase II trials, observational studies, and expert consensus.