Mobility Levels of Critically Ill Adult Patients and Extubation Success.

Abstract

Background: Reduced mobility in patients who are critically ill is still a reality in many ICUs. This study aimed to investigate if the mobility level is associated with an extubation outcome in adult subjects. Methods: This was a prospective cohort study composed of adults who had undergone initial invasive mechanical ventilation for > 24 h and who were independently mobile before hospitalization. Subject progress was monitored from ICU admission to discharge. Data were collected daily from medical records and multidisciplinary teams by considering variables such as age, sex, body mass index, Simplified Acute Physiology Score III, type of ICU admission, comorbidities, sedation, use of vasoactive drugs, neuromuscular blockers, duration of mechanical ventilation, and ICU Mobility Scale. The primary outcome was the success of extubation. Results: ICU Mobility Scale values was not directly associated with extubation outcome. Older subjects demonstrated a reduced tendency for high ICU Mobility Scale values, as did those on prolonged usage of vasoactive drugs or mechanical ventilation. Subjects with higher ICU Mobility Scale values achieved successful extubation earlier, which suggests a link between mobility and faster extubation success. Conclusions: The level of mobility assessed 24 h after extubation was not associated with extubation success. The following characteristics were associated with a lower propensity to present a high ICU Mobility Scale value: older age, greater number of days of use of vasoactive drugs and mechanical ventilation. Subjects with higher levels of mobility had a successful extubation event earlier in the ICU course. Studies that assess mobility on a continuous basis would be more precise in identifying this association.