It's been suggested that early mobilization of patients in the ICU may reduce the length of hospital stay and improve function at discharge, but guidelines don't specify the appropriate timing or regimen. In an international, multicenter, randomized controlled trial, 750 adults undergoing mechanical ventilation in the ICU were randomized to early mobilization (sedation minimization and daily physiotherapy) or usual care (the mobilization level usually provided in each ICU).

The mean daily duration of active mobilization per patient was 20.8 minutes in the early mobilization group and 8.8 minutes in the usual care group. By day 180, the median number of days patients were alive and out of the hospital was 143 in the early mobilization group and 145 in the usual care group. By day 180, 22.5% of patients in the early mobilization group and 19.5% of those in the usual care group had died. The number of ventilator-free days was similar in the two groups. Among survivors, patient-reported outcomes regarding quality of life, activities of daily living, and disability were also similar in the two groups, as were secondary outcomes, including 28-day mortality and cognitive and psychological function. Adverse events that were potentially due to mobilization occurred in 9.2% of patients in the early mobilization group and 4.1% in the usual care group. The most common adverse events reported were cardiac arrhythmia, altered blood pressure, and oxygen desaturation.

The authors point out that patients in the usual care group in this study received more mobilization than usual-care patients received in some other studies. Furthermore, although treatment was provided according to the study protocol, changes in practice that could have affected treatment in the usual care group might have occurred at some sites. In addition, some patients weren't actively mobilized in the ICU, reducing the statistical power to detect between-group differences.