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Current Concepts in Early Mobilization of Critically Ill Patients Within the Context of Neurologic Pathology

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Abstract

Neurocritical patients (NCPs) in the intensive care unit (ICU) rapidly progress to respiratory and peripheral muscle dysfunctions, which significantly impact morbidity and death. Early mobilization in NCPs to decrease the incidence of ICU–acquired weakness has been showing rapid growth, although pertinent literature is still scarce. With this review, we summarize and discuss current concepts in early mobilization of critically ill patients within the context of neurologic pathology in NCPs. A narrative synthesis of literature was undertaken trying to answer the following questions: How do the respiratory and musculoskeletal systems in NCPs behave? Which metabolic biomarkers influence physiological responses in NCPs? Which considerations should be taken when prescribing exercises in neurocritically ill patients? The present review detected safety, feasibility, and beneficial response for early mobilization in NCPs, given successes in other critically ill populations and many smaller intervention trials in neurocritical care. However, precautions should be taken to elect the patient for early care, as well as monitoring signs that indicate interruption for intervention, as worse outcomes were associated with very early mobilization in acute stroke trials.

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  1. Post Graduation Program in Rehabilitation and Functional Performance, Universidade de Pernambuco, BR 203, Km 2, s/n, Vila Eduardo, 56, Petrolina, Pernambuco, 328-900, Brazil

    Thaís Ferreira Lopes Diniz Maia, Paulo André Freire Magalhães, Dasdores Tatiana Silva Santos, Jorge Luiz de Brito Gomes, Paulo Adriano Schwingel & Aline de Freitas Brito

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TM: Determination of search criteria and eligibility of articles, literary search, manuscript preparation, and manuscript review. PM: writing-reviewing and editing. DS: determination of search criteria and eligibility of articles, literary search, and manuscript review. JG: writing-reviewing and editing. PS: writing-reviewing and editing. AB: determination of search criteria and eligibility of articles, literary search, and manuscript review. The final manuscript was approved by all authors.

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Maia, T.F.L.D., Magalhães, P.A.F., Santos, D.T.S. et al. Current Concepts in Early Mobilization of Critically Ill Patients Within the Context of Neurologic Pathology. Neurocrit Care (2024). https://doi.org/10.1007/s12028-023-01934-8

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