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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