Early mobilization to prevent ICU-acquired weakness in mechanically ventilated patients: an integrative review.

Background: Intensive Care Unit-acquired weakness (ICU-AW) is a prevalent and serious complication in critically ill patients, leading to difficulty in weaning from mechanical ventilation, prolonged hospital stays, and impaired functional status after discharge. Aim: To retrieve, evaluate, and integrate the best evidence for preventing ICU-AW through early mobilization in mechanically ventilated patients, and to provide references for clinical practice. Methods: Following the "5S" pyramid model, a top-down, systematic retrieval was conducted across domestic and international databases. The types of literature encompass clinical decisions, guidelines, evidence summaries, best practices, expert consensus, group standards, and systematic reviews. Results: A total of 22 studies were included, comprising 1 evidence summary, 3 guidelines, 3 expert consensus statements, and 15 systematic reviews. 27 pieces of evidence were extracted from these articles, covering 9 areas: establishment of a multidisciplinary rehabilitation team, timing of mobilization, mobilization assessment, mobilization methods, frequency and intensity of exercise, pre-mobilization preparation, mobilization monitoring, post-mobilization observation, and precautions. Conclusion: This study presents key evidence on early mobilization to prevent ICU-AW in mechanically ventilated patients, highlighting its role in improving patient outcomes. Systematic assessment, timely initiation, individualized mobilization plans, progressive exercise protocols, continuous monitoring, and multidisciplinary collaboration are essential for the effective and safe implementation of mobilization. Early passive and active mobilization can reduce the incidence of ICU-AW, shorten ventilation and ICU stay, and improve functional status at discharge. Systematic review registration: http://ebn.nursing.fudan.edu.cn/registerResources, identifier ES20245841.