• Intensive care medicine · Aug 2024

    Practice Guideline

    Guideline on positioning and early mobilisation in the critically ill by an expert panel.

    • Stefan J Schaller, Flora T Scheffenbichler, Thomas Bein, Manfred Blobner, Julius J Grunow, Uwe Hamsen, Carsten Hermes, Arnold Kaltwasser, Heidrun Lewald, Peter Nydahl, Anett Reißhauer, Leonie Renzewitz, Karsten Siemon, Thomas Staudinger, Roman Ullrich, Steffen Weber-Carstens, Hermann Wrigge, Dominik Zergiebel, and Sina M Coldewey.
    • Department of Anaesthesiology and Intensive Care Medicine (CCM/CVK), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany. stefan.schaller@charite.de.
    • Intensive Care Med. 2024 Aug 1; 50 (8): 121112271211-1227.

    AbstractA scientific panel was created consisting of 23 interdisciplinary and interprofessional experts in intensive care medicine, physiotherapy, nursing care, surgery, rehabilitative medicine, and pneumology delegated from scientific societies together with a patient representative and a delegate from the Association of the Scientific Medical Societies who advised methodological implementation. The guideline was created according to the German Association of the Scientific Medical Societies (AWMF), based on The Appraisal of Guidelines for Research and Evaluation (AGREE) II. The topics of (early) mobilisation, neuromuscular electrical stimulation, assist devices for mobilisation, and positioning, including prone positioning, were identified as areas to be addressed and assigned to specialist expert groups, taking conflicts of interest into account. The panel formulated PICO questions (addressing the population, intervention, comparison or control group as well as the resulting outcomes), conducted a systematic literature review with abstract screening and full-text analysis and created summary tables. This was followed by grading the evidence according to the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence and a risk of bias assessment. The recommendations were finalized according to GRADE and voted using an online Delphi process followed by a final hybrid consensus conference. The German long version of the guideline was approved by the professional associations. For this English version an update of the systematic review was conducted until April 2024 and recommendation adapted based on new evidence in systematic reviews and randomized controlled trials. In total, 46 recommendations were developed and research gaps addressed.© 2024. The Author(s).

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