4.8 Letter

Early Active Mobilization during Mechanical Ventilation in the ICU

Journal

NEW ENGLAND JOURNAL OF MEDICINE
Volume 388, Issue 6, Pages 572-574

Publisher

MASSACHUSETTS MEDICAL SOC
DOI: 10.1056/NEJMc2216086

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Previous investigations have shown that oversedation and immobilization of mechanically ventilated patients are associated with or result in greater length of hospital stay, decreased survival, and greater incidence of acquired dementia. The evidence-based ABCDEF safety bundle helps us rehumanize care and establish higher adherence to key steps; E (for early mobility) yields dose-response results of earlier discharge and greater survival.
To the Editor: Previous investigations have shown that oversedation and immobilization of mechanically ventilated patients are associated with or result in greater length of hospital stay, decreased survival, and greater incidence of acquired dementia.(1-3) The evidence-based ABCDEF (analgesia monitoring and management, breaks daily from both sedation and ventilator use, choice of sedation [avoiding benzodiazepines], delirium monitoring and management, early mobility, and family engagement) safety bundle helps us rehumanize care and establish higher adherence to key steps; E (for early mobility) yields dose-response results of earlier discharge and greater survival.(4) The TEAM (Treatment of Mechanically Ventilated Adults with Early Activity and . . .

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