Association of the mobility level of critically ill adult patients with the success of extubation: protocol for a cohort study

• Published in: BMJ open 2021-07, Vol.11 (7), p.e040693-e040693
• Main Authors: Pal, Camila, Fu, Carolina, Carvalho, Carlos Roberto Ribeiro, Auler Júnior, José Otávio Costa, Yamauchi, Liria Yuri
• Format: Article
• Language: English
• Subjects: Amputation; Anesthesia; Body mass index; Cohort analysis; Consciousness; Extubation; Hospitals; Intensive Care; Intubation; Length of stay; Medical prognosis; Mortality; Multidisciplinary teams; Muscle strength; Ostomy; Patients; Success; Surgery; Survival analysis; Variables; Ventilators; Weaning
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2020-040693

IntroductionSeveral factors contribute to the reduction of the mobility in ICU), such as the use of sedatives, severity, invasive devices, acute clinical instability, lack of resources, the culture of immobility, architectural barriers and the own weakness developed in the ICU. The need for ventilatory support is common in most of patients, and weaning from mechanical ventilation (MV) is an arduous process that requires the commitment of the entire team. Instruments that objectively assess the mobility of patients admitted to the ICU can be useful to identify the existence or not of an association between mobility and prognosis.ObjectiveTo estimate the association between the level of mobility and successful extubation.Methods and analysisProspective cohort study with the beginning of follow-up when the patient completes 24 hours of invasive MV in the ICU and ends on the date the patient’s hospital discharge. Adult patients (≥18 years old) admitted to the ICU will be included in the first invasive MV event in this hospitalisation. Patients should be independently able to mobilise before current hospital admission. Predictor variables will be collected (age, sex, body mass index, Simplified Acute Physiological Score III (SAPS III), ICU admission type: clinic, elective or emergency surgery postoperative, Charlson Index, number of physiotherapists per patient in each ICU, use of sedation, vasoactive drugs and neuromuscular blocker, ICU mobility scale, time of invasive MV, ICU admission and hospital admission, and outcome. The primary outcome is the result of extubation (success or failure).Ethics and disseminationThis study was approved by the Ethics Committee, certificate number 92878218.1.0000.5505. The protocol was registered on the Registro Brasileiro de Ensaios Clínicos (ReBEC) (registration number RBR-8k4f68). The results will be published in specialised journals and disseminated to the medical society and the general public.