Effects of early mobilization on the incidence of delirium in the ICU

review of systematic reviews

Abstract

INTRODUCTION: Delirium is understood as an acute change in mental state, with a wide variety of neuropsychiatric signs and symptoms, with a fluctuating course and explained by disorders in cerebral homeostasis. Early mobilization (EM) is defined as an energy-consuming activity that aims to maintain or support the patient’s mobility through passive or active movement exercises. Objective: to review knowledge about the effects of EM on delirium in critically ill patients in hospital. Methods: a literature review, with research in the PubMed database, using meta-analyses published between 2014 and 2024, in English, using the terms: delirium, intensive care units and rehabilitation. Results: 7 articles discussing EM in intensive care units were included, and conflicting and inconclusive results were found on the effects of EM in relation to the duration and incidence of delirium and functional outcomes. A single strategy for performing EM was also not defined, the ABCDEF bundle obtained the most favorable results in relation to functional outcomes, incidence and duration of delirium. Conclusion: EM is both viable and safe, being an important tool in the multidisciplinary care of critically ill patients, however its use for delirium has demonstrated conflicting results. The available studies present large methodological differences, a small population studied, and, in general, few studies addressing the subject. We emphasize the need for further studies to be able to define both the effectiveness of the EM and a protocol for its implementation.