A Binational Multicenter Pilot Feasibility Randomized Controlled Trial of Early Goal-Directed Mobilization in the ICU*

<jats:sec> <jats:title>Objectives:</jats:title> <jats:p>To determine if the early goal-directed mobilization intervention could be delivered to patients receiving mechanical ventilation with increased maximal levels of activity compared with standard care.</jats:p> </jats:sec> <jats:sec> <jats:title>Design:</jats:title> <jats:p>A pilot randomized controlled trial.</jats:p> </jats:sec> <jats:sec> <jats:title>Setting:</jats:title> <jats:p>Five ICUs in Australia and New Zealand.</jats:p> </jats:sec> <jats:sec> <jats:title>Participants:</jats:title> <jats:p>Fifty critically ill adults mechanically ventilated for greater than 24 hours.</jats:p> </jats:sec> <jats:sec> <jats:title>Intervention:</jats:title> <jats:p>Patients were randomly assigned to either early goal-directed mobilization (intervention) or to standard care (control). Early goal-directed mobilization comprised functional rehabilitation treatment conducted at the highest level of activity possible for that patient assessed by the ICU mobility scale while receiving mechanical ventilation.</jats:p> </jats:sec> <jats:sec> <jats:title>Measurements and Main Results:</jats:title> <jats:p>The ICU mobility scale, strength, ventilation duration, ICU and hospital length of stay, and total inpatient (acute and rehabilitation) stay as well as 6-month post-ICU discharge health-related quality of life, activities of daily living, and anxiety and depression were recorded. The mean age was 61 years and 60% were men. The highest level of activity (ICU mobility scale) recorded during the ICU stay between the intervention and control groups was mean (95% CI) 7.3 (6.3–8.3) versus 5.9 (4.9–6.9), <jats:italic toggle="yes">p</jats:italic> = 0.05. The proportion of patients who walked in ICU was almost doubled with early goal-directed mobilization (intervention <jats:italic toggle="yes">n</jats:italic> = 19 [66%] vs control <jats:italic toggle="yes">n</jats:italic> = 8 [38%]; <jats:italic toggle="yes">p</jats:italic> = 0.05). There was no difference in total inpatient stay (d) between the intervention versus control groups (20 [15–35] vs 34 [18–43]; <jats:italic toggle="yes">p</jats:italic> = 0.37). There were no adverse events.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>Key Practice Points: Delivery of early goal-directed mobilization within a randomized controlled trial was feasible, safe and resulted in increased duration and level of active exercises.</jats:p> </jats:sec>