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Table 1 Summary of included studies and study participants

From: Systematic early versus late mobilization or standard early mobilization in mechanically ventilated adult ICU patients: systematic review and meta-analysis

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
  1. 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
  2. aThree-arm trial
  3. bAPACHE III score