Critérios de segurança para iniciar a mobilização precoce em unidades de terapia intensiva. Revisão sistemática

Conceição, Thais Martins Albanaz da; Gonzáles, Ana Inês; Figueiredo, Fernanda Cabral Xavier Sarmento de; Vieira, Danielle Soares Rocha; Bündchen, Daiana Cristine

doi:10.5935/0103-507X.20170076

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Brasil

Revista Brasileira de Terapia Intensiva

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Sumário

ARTIGOS DE REVISÃO • Rev. bras. ter. intensiva 29 (4) • Oct-Dec 2017 • https://doi.org/10.5935/0103-507X.20170076 copiar

Critérios de segurança para iniciar a mobilização precoce em unidades de terapia intensiva. Revisão sistemática

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO

Pacientes críticos internados em unidade de terapia intensiva devem ser mobilizados com base em critérios de segurança. O objetivo desta revisão foi verificar os critérios de segurança mais utilizados para iniciar a mobilização precoce em pacientes sob ventilação mecânica internados em unidade de terapia intensiva. Os artigos foram pesquisados nas bases de dados PubMed, PEDro, LILACS, Cochrane e CINAHL, tendo sido incluídos ensaios clínicos randomizados e controlados, ensaios clínicos quase randomizados, coortes, estudos comparativos com ou sem controles simultâneos, séries de casos com dez ou mais casos consecutivos, e estudos descritivos. O mesmo foi feito para estudos prospectivos, retrospectivos e transversais, nos quais, em sua metodologia, deveria constar a descrição dos critérios de segurança utilizados para iniciar a mobilização precoce. Dois revisores selecionaram, independentemente, estudos em potencial, de acordo com os critérios de inclusão, extraíram os dados e avaliaram a qualidade metodológica. Na análise dos dados, foi utilizada descrição narrativa para resumir as características e os resultados dos estudos obtidos, sendo os critérios de segurança categorizados nos seguintes subgrupos: cardiovasculares, respiratórios, neurológicos, ortopédicos e outros. Obtivemos 37 estudos elegíveis. O critério de segurança cardiovascular apresentou o maior número de variáveis identificadas. No entanto, o critério de segurança respiratório apresentou maior concordância. Houve maior divergência entre os autores em relação aos critérios neurológicos. Faz-se necessário reforçar o reconhecimento dos critérios de segurança utilizados para segurança da mobilização precoce do paciente crítico, ao mesmo tempo em que os parâmetros e as variáveis encontradas poderão auxiliar na incorporação à rotina dos serviços, com a intenção de iniciar, progredir e guiar a prática clínica.

Descritores:
Hospitalização; Reabilitação; Respiração artificial; Deambulação precoce; Cuidados críticos; Segurança do paciente

Critérios	Schweickert et al.⁽⁹9 Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009;373(9678):1874-82.⁾	Collings et al.⁽¹³13 Collings N, Cusack R. A repeated measures, randomised cross-over trial, comparing the acute exercise response between passive and active sitting in critically ill patients. BMC Anesthesiol. 2015;15:1.⁾	Médrinal et al.⁽²³23 Médrinal C, Lebret M, Bousta M, Nassaj A, Colas G. Effects of sitting at the bedside of the patient with mechanical ventilation. Kinesitherapie Revue. 2013;13(138):43-9.⁾	Nava⁽³⁰30 Nava S. Rehabilitation of patients admitted to a respiratory intensive care unit. Arch Phys Med Rehabil. 1998;79(7):849-54.⁾	Dantas et al.⁽³¹31 Dantas CM, Silva PF, Siqueira FH, Pinto RM, Matias S, Maciel C, et al. Influence of early mobilization on respiratory and peripheral muscle strength in critically ill patients. Rev Bras Ter Intensiva. 2012;24(2):173-8.⁾	Dong et al.⁽³²32 Dong ZH, Yu BX, Sun YB, Fang W, Li L. Effects of early rehabilitation therapy on patients with mechanical ventilation. World J Emerg Med. 2014;5(1):48-52.⁾
Critérios de elegibilidade ^* * Não somado na pontuação final.	Sim	Sim	Sim	Sim	Sim	Sim
Seleção randomizada	Sim	Sim	Sim	Sim	Sim	Sim
Alocação secreta	Sim	Não	Sim	Não	Não	Não
Homogeneidade pré-tratamento	Sim	Sim	Não	Sim	Sim	Sim
Sujeitos cegos	Não	Não	Não	Não	Não	Não
Terapeutas cegos	Não	Não	Não	Não	Não	Não
Avaliadores cegos	Sim	Não	Não	Não	Não	Não
Acompanhamento adequado	Sim	Sim	Sim	Não	Sim	Não
Intenção de tratamento	Sim	Sim	Sim	Não	Sim	Sim
Comparação entre grupos	Sim	Sim	Sim	Sim	Sim	Sim

Critérios	Variáveis	Parâmetros	Referências
Cardiovasculares	Frequência cardíaca	> 40bpm e < 130bpm	Pohlman et al.,⁽²2 Pohlman MC, Schweickert WD, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Feasibility of physical and occupational therapy beginning from initiation of mechanical ventilation. Crit Care Med. 2010;38(11):2089-94.⁾ Davis et al.,⁽²⁴24 Davis J, Crawford K, Wierman H, Osgood W, Cavanaugh J, Smith KA, et al. Mobilization of ventilated older adults. J Geriatr Phys Ther. 2013;36(4):162-8.⁾ Schweickert et al.,⁽⁹9 Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009;373(9678):1874-82.⁾ Dong et al.,⁽³²32 Dong ZH, Yu BX, Sun YB, Fang W, Li L. Effects of early rehabilitation therapy on patients with mechanical ventilation. World J Emerg Med. 2014;5(1):48-52.⁾ Brummel et al.⁽³³33 Brummel NE, Jackson JC, Girard TD, Pandharipande PP, Schiro E, Work B, et al. A combined early cognitive and physical rehabilitation program for people who are critically ill: the activity and cognitive therapy in the intensive care unit (ACT-ICU) trial. Phys Ther. 2012;92(12):1580-92.⁾ e Harris et al.⁽³⁴34 Harris CL, Shahid S. Physical therapy-driven quality improvement to promote early mobility in the intensive care unit. Proc (Bayl Univ Med Cent). 2014;27(3):203-7.⁾
	Pressão arterial sistólica	< 180mmHg	Brummel et al.,⁽³³33 Brummel NE, Jackson JC, Girard TD, Pandharipande PP, Schiro E, Work B, et al. A combined early cognitive and physical rehabilitation program for people who are critically ill: the activity and cognitive therapy in the intensive care unit (ACT-ICU) trial. Phys Ther. 2012;92(12):1580-92.⁾ Harris et al.⁽³⁴34 Harris CL, Shahid S. Physical therapy-driven quality improvement to promote early mobility in the intensive care unit. Proc (Bayl Univ Med Cent). 2014;27(3):203-7.⁾ e Dammeyer et al.⁽³⁶36 Dammeyer JA, Baldwin N, Packard D, Harrington S, Christofferson B, Christopher J, et al. Mobilizing outcomes: implementation of a nurse-led multidisciplinary mobility program. Crit Care Nurs Q. 2013;36(1):109-19.⁾
		> 90mmHg < 200mmHg	Davis et al.,⁽²⁴24 Davis J, Crawford K, Wierman H, Osgood W, Cavanaugh J, Smith KA, et al. Mobilization of ventilated older adults. J Geriatr Phys Ther. 2013;36(4):162-8.⁾ Schweickert et al.,⁽⁹9 Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009;373(9678):1874-82.⁾ Dantas et al.,⁽³¹31 Dantas CM, Silva PF, Siqueira FH, Pinto RM, Matias S, Maciel C, et al. Influence of early mobilization on respiratory and peripheral muscle strength in critically ill patients. Rev Bras Ter Intensiva. 2012;24(2):173-8.⁾ Timmerman,⁽³⁷37 Timmerman RA. A mobility protocol for critically ill adults. Dimens Crit Care Nurs. 2007;26(5):175-9; quiz 180-1.⁾ Lee et al.⁽²⁵25 Lee H, Ko YJ, Suh GY, Yang JH, Park CM, Jeon K, et al. Safety profile and feasibility of early physical therapy and mobility for critically ill patients in the medical intensive care unit: Beginning experiences in Korea. J Crit Care. 2015;30(4):673-7.⁾ e Bourdin et al.⁽³⁸38 Bourdin G, Barbier J, Burle JF, Durante G, Passant S, Vincent B, et al. The feasibility of early physical activity in intensive care unit patients: a prospective observational one-center study. Respir Care. 2010;55(4):400-7.⁾
	Pressão arterial média	> 60mmHg	Dammeyer et al.,⁽³⁶36 Dammeyer JA, Baldwin N, Packard D, Harrington S, Christofferson B, Christopher J, et al. Mobilizing outcomes: implementation of a nurse-led multidisciplinary mobility program. Crit Care Nurs Q. 2013;36(1):109-19.⁾ Segers et al.⁽³⁹39 Segers J, Hermans G, Bruyninckx F, Meyfroidt G, Langer D, Gosselink R. Feasibility of neuromuscular electrical stimulation in critically ill patients. J Crit Care. 2014;29(6):1082-8.⁾ e Engel et al.⁽⁴⁰40 Engel HJ, Tatebe S, Alonzo PB, Mustille RL, Rivera MJ. Physical therapist-established intensive care unit early mobilization program: quality improvement project for critical care at the University of California San Francisco Medical Center. Phys Ther. 2013;93(7):975-85.⁾
		> 60mmHg < 110mmHg	Perme et al.,⁽¹²12 Perme C, Chandrashekar R. Early mobility and walking program for patients in intensive care units: creating a standard of care. Am J Crit Care. 2009;18(3):212-21.⁾ Perme et al.,⁽³⁵35 Perme C, Nalty T, Winkelman C, Kenji Nawa R, Masud F. Safety and efficacy of mobility interventions in patients with femoral catheters in the ICU: a prospective observational study. Cardiopulm Phys Ther J. 2013;24(2):12-7.⁾ e Mah et al.⁽⁴¹41 Mah JW, Staff I, Fichandler D, Butler KL. Resource-efficient mobilization programs in the intensive care unit: who stands to win? Am J Surg. 2013;206(4):488-93.⁾
		> 65mmHg < 110mmHg	Davis et al.,⁽²⁴24 Davis J, Crawford K, Wierman H, Osgood W, Cavanaugh J, Smith KA, et al. Mobilization of ventilated older adults. J Geriatr Phys Ther. 2013;36(4):162-8.⁾ Schweickert et al.,⁽⁹9 Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009;373(9678):1874-82.⁾ Dong et al.⁽³²32 Dong ZH, Yu BX, Sun YB, Fang W, Li L. Effects of early rehabilitation therapy on patients with mechanical ventilation. World J Emerg Med. 2014;5(1):48-52.⁾ e Lee et al.⁽²⁵25 Lee H, Ko YJ, Suh GY, Yang JH, Park CM, Jeon K, et al. Safety profile and feasibility of early physical therapy and mobility for critically ill patients in the medical intensive care unit: Beginning experiences in Korea. J Crit Care. 2015;30(4):673-7.⁾
	Estabilidade hemodinâmica	--	Clark et al.,⁽¹¹11 Clark DE, Lowman JD, Griffin RL, Matthews HM, Reiff DA. Effectiveness of an early mobilization protocol in a trauma and burns intensive care unit: a retrospective cohort study. Phys Ther. 2013;93(2):186-96.⁾ Collings et al.,⁽¹³13 Collings N, Cusack R. A repeated measures, randomised cross-over trial, comparing the acute exercise response between passive and active sitting in critically ill patients. BMC Anesthesiol. 2015;15:1.⁾ Perme et al.,⁽³⁵35 Perme C, Nalty T, Winkelman C, Kenji Nawa R, Masud F. Safety and efficacy of mobility interventions in patients with femoral catheters in the ICU: a prospective observational study. Cardiopulm Phys Ther J. 2013;24(2):12-7.⁾ Engel et al.,⁽⁴⁰40 Engel HJ, Tatebe S, Alonzo PB, Mustille RL, Rivera MJ. Physical therapist-established intensive care unit early mobilization program: quality improvement project for critical care at the University of California San Francisco Medical Center. Phys Ther. 2013;93(7):975-85.⁾ Mah et al.,⁽⁴¹41 Mah JW, Staff I, Fichandler D, Butler KL. Resource-efficient mobilization programs in the intensive care unit: who stands to win? Am J Surg. 2013;206(4):488-93.⁾ Dickinson et al.⁽⁴²42 Dickinson S, Tschannen D, Shever LL. Can the use of an early mobility program reduce the incidence of pressure ulcers in a surgical critical care unit? Crit Care Nurs Q. 2013;36(1):127-40.⁾ e Titsworth et al.⁽⁴³43 Titsworth WL, Hester J, Correia T, Reed R, Guin P, Archibald L, et al. The effect of increased mobility on morbidity in the neurointensive care unit. J Neurosurg. 2012;116(6):1379-88.⁾
	Ausência de droga vasoativa	--	Bourdin et al.,⁽38⁾ Ronnebaum et al.,⁽⁴⁴44 Ronnebaum JA, Weir JP, Hilsabeck TA. Earlier mobilization decreases the length of stay in the intensive care unit. J Acute Care Phys Ther. 2012;3(2):204-10.⁾ Thomsen et al.⁽⁴⁵45 Thomsen GE, Snow GL, Rodriguez L, Hopkins RO. Patients with respiratory failure increase ambulation after transfer to an intensive care unit where early activity is a priority. Crit Care Med. 2008;36(4):1119-24.⁾ e Bailey et al.⁽¹⁰10 Bailey P, Thomsen GE, Spuhler VJ, Blair R, Jewkes J, Bezdjian L, et al. Early activity is feasible and safe in respiratory failure patients. Crit Care Med. 2007;35(1):139-45.⁾
	Ausência de aumento de dose vasopressora nas últimas 2 horas	--	Davis et al.,⁽²⁴24 Davis J, Crawford K, Wierman H, Osgood W, Cavanaugh J, Smith KA, et al. Mobilization of ventilated older adults. J Geriatr Phys Ther. 2013;36(4):162-8.⁾ Needham et al.,⁽¹⁴14 Needham DM, Korupolu R. Rehabilitation quality improvement in an intensive care unit setting: implementation of a quality improvement model. Top Stroke Rehabil. 2010;17(4):271-81.⁾ Brummel et al.,⁽³³33 Brummel NE, Jackson JC, Girard TD, Pandharipande PP, Schiro E, Work B, et al. A combined early cognitive and physical rehabilitation program for people who are critically ill: the activity and cognitive therapy in the intensive care unit (ACT-ICU) trial. Phys Ther. 2012;92(12):1580-92.⁾ Needham et al.⁽⁴⁶46 Needham DM, Korupolu R, Zanni JM, Pradhan P, Colantuoni E, Palmer JB, et al. Early physical medicine and rehabilitation for patients with acute respiratory failure: a quality improvement project. Arch Phys Med Rehabil. 2010;91(4):536-42.⁾ e Balas et al.⁽⁴⁷47 Balas MC, Vasilevskis EE, Olsen KM, Schmid KK, Shostrom V, Cohen MZ, et al. Effectiveness and safety of the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle. Crit Care Med. 2014;42(5):1024-36.⁾
	Ausência de isquemia miocárdica	--	Pohlman et al.,⁽2⁾ Needham et al.,⁽¹⁴14 Needham DM, Korupolu R. Rehabilitation quality improvement in an intensive care unit setting: implementation of a quality improvement model. Top Stroke Rehabil. 2010;17(4):271-81.⁾ Schweickert et al.,⁽⁹9 Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009;373(9678):1874-82.⁾ Dammeyer et al.,⁽³⁶36 Dammeyer JA, Baldwin N, Packard D, Harrington S, Christofferson B, Christopher J, et al. Mobilizing outcomes: implementation of a nurse-led multidisciplinary mobility program. Crit Care Nurs Q. 2013;36(1):109-19.⁾ Balas et al.,⁽⁴⁷47 Balas MC, Vasilevskis EE, Olsen KM, Schmid KK, Shostrom V, Cohen MZ, et al. Effectiveness and safety of the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle. Crit Care Med. 2014;42(5):1024-36.⁾ Wang et al.,⁽⁴⁸48 Wang YT, Haines TP, Ritchie P, Walker C, Ansell TA, Ryan DT, et al. Early mobilization on continuous renal replacement therapy is safe and may improve filter life. Crit Care. 2014;18(4): R161.⁾ Berney et al.⁽⁴⁹49 Berney S, Haines K, Skinner EH, Denehy L. Safety and feasibility of an exercise prescription approach to rehabilitation across the continuum of care for survivors of critical illness. Phys Ther. 2012;92(12):1524-35.⁾ e Drolet et al.⁽⁵⁰50 Drolet A, DeJuilio P, Harkless S, Henricks S, Kamin E, Leddy EA, et al. Move to improve: the feasibility of using an early mobility protocol to increase ambulation in the intensive and intermediate care settings. Phys Ther. 2013;93(2):197-207.⁾
	Ausência de arritmia	--	Abrams et al.,⁽²¹21 Abrams D, Javidfar J, Farrand E, Mongero LB, Agerstrand CL, Ryan P, et al. Early mobilization of patients receiving extracorporeal membrane oxygenation: a retrospective cohort study. Crit Care. 2014;18(1):R38.⁾ Nava,⁽30⁾ Dammeyer et al.,⁽³⁶36 Dammeyer JA, Baldwin N, Packard D, Harrington S, Christofferson B, Christopher J, et al. Mobilizing outcomes: implementation of a nurse-led multidisciplinary mobility program. Crit Care Nurs Q. 2013;36(1):109-19.⁾ Timmerman,⁽³⁷37 Timmerman RA. A mobility protocol for critically ill adults. Dimens Crit Care Nurs. 2007;26(5):175-9; quiz 180-1.⁾ Lee et al.,⁽²⁵25 Lee H, Ko YJ, Suh GY, Yang JH, Park CM, Jeon K, et al. Safety profile and feasibility of early physical therapy and mobility for critically ill patients in the medical intensive care unit: Beginning experiences in Korea. J Crit Care. 2015;30(4):673-7.⁾ Dickinson et al.,⁽⁴²42 Dickinson S, Tschannen D, Shever LL. Can the use of an early mobility program reduce the incidence of pressure ulcers in a surgical critical care unit? Crit Care Nurs Q. 2013;36(1):127-40.⁾ Wang et al.,⁽⁴⁸48 Wang YT, Haines TP, Ritchie P, Walker C, Ansell TA, Ryan DT, et al. Early mobilization on continuous renal replacement therapy is safe and may improve filter life. Crit Care. 2014;18(4): R161.⁾ Berney et al.⁽⁴⁹49 Berney S, Haines K, Skinner EH, Denehy L. Safety and feasibility of an exercise prescription approach to rehabilitation across the continuum of care for survivors of critical illness. Phys Ther. 2012;92(12):1524-35.⁾ e Drolet et al.⁽⁵⁰50 Drolet A, DeJuilio P, Harkless S, Henricks S, Kamin E, Leddy EA, et al. Move to improve: the feasibility of using an early mobility protocol to increase ambulation in the intensive and intermediate care settings. Phys Ther. 2013;93(2):197-207.⁾
	Ausência de cateter na artéria femoral	--	Clark et al.,⁽¹¹11 Clark DE, Lowman JD, Griffin RL, Matthews HM, Reiff DA. Effectiveness of an early mobilization protocol in a trauma and burns intensive care unit: a retrospective cohort study. Phys Ther. 2013;93(2):186-96.⁾ Brummel et al.⁽³³33 Brummel NE, Jackson JC, Girard TD, Pandharipande PP, Schiro E, Work B, et al. A combined early cognitive and physical rehabilitation program for people who are critically ill: the activity and cognitive therapy in the intensive care unit (ACT-ICU) trial. Phys Ther. 2012;92(12):1580-92.⁾ e Timmerman⁽³⁷37 Timmerman RA. A mobility protocol for critically ill adults. Dimens Crit Care Nurs. 2007;26(5):175-9; quiz 180-1.⁾
	Ausência de nova administração de agente antiarrítmico	--	Needham et al.,⁽¹⁴14 Needham DM, Korupolu R. Rehabilitation quality improvement in an intensive care unit setting: implementation of a quality improvement model. Top Stroke Rehabil. 2010;17(4):271-81.⁾ Balas et al.⁽⁴⁷47 Balas MC, Vasilevskis EE, Olsen KM, Schmid KK, Shostrom V, Cohen MZ, et al. Effectiveness and safety of the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle. Crit Care Med. 2014;42(5):1024-36.⁾ e Drolet et al.⁽⁵⁰50 Drolet A, DeJuilio P, Harkless S, Henricks S, Kamin E, Leddy EA, et al. Move to improve: the feasibility of using an early mobility protocol to increase ambulation in the intensive and intermediate care settings. Phys Ther. 2013;93(2):197-207.⁾
Respiratórios	Frequência respiratória	> 5rpm e/ou < 40rpm	Pohlman et al.,⁽²2 Pohlman MC, Schweickert WD, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Feasibility of physical and occupational therapy beginning from initiation of mechanical ventilation. Crit Care Med. 2010;38(11):2089-94.⁾ Davis et al.,⁽²⁴24 Davis J, Crawford K, Wierman H, Osgood W, Cavanaugh J, Smith KA, et al. Mobilization of ventilated older adults. J Geriatr Phys Ther. 2013;36(4):162-8.⁾ Schweickert et al.,⁽⁹9 Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009;373(9678):1874-82.⁾ Médrinal et al.,⁽²³23 Médrinal C, Lebret M, Bousta M, Nassaj A, Colas G. Effects of sitting at the bedside of the patient with mechanical ventilation. Kinesitherapie Revue. 2013;13(138):43-9.⁾ Dong et al.,⁽³²32 Dong ZH, Yu BX, Sun YB, Fang W, Li L. Effects of early rehabilitation therapy on patients with mechanical ventilation. World J Emerg Med. 2014;5(1):48-52.⁾ Brummel et al.,⁽³³33 Brummel NE, Jackson JC, Girard TD, Pandharipande PP, Schiro E, Work B, et al. A combined early cognitive and physical rehabilitation program for people who are critically ill: the activity and cognitive therapy in the intensive care unit (ACT-ICU) trial. Phys Ther. 2012;92(12):1580-92.⁾ Harris et al.,⁽³⁴34 Harris CL, Shahid S. Physical therapy-driven quality improvement to promote early mobility in the intensive care unit. Proc (Bayl Univ Med Cent). 2014;27(3):203-7.⁾ Dammeyer et al.⁽³⁶36 Dammeyer JA, Baldwin N, Packard D, Harrington S, Christofferson B, Christopher J, et al. Mobilizing outcomes: implementation of a nurse-led multidisciplinary mobility program. Crit Care Nurs Q. 2013;36(1):109-19.⁾ e Olkowski et al.⁽⁵¹51 Olkowski BF, Devine MA, Slotnick LE, Veznedaroglu E, Liebman KM, Arcaro ML, et al. Safety and feasibility of an early mobilization program for patients with aneurysmal subarachnoid hemorrhage. Phys Ther. 2013;93(2):208-15.⁾
		< 35rpm	Timmerman,⁽³⁷37 Timmerman RA. A mobility protocol for critically ill adults. Dimens Crit Care Nurs. 2007;26(5):175-9; quiz 180-1.⁾ Lee et al.,⁽²⁵25 Lee H, Ko YJ, Suh GY, Yang JH, Park CM, Jeon K, et al. Safety profile and feasibility of early physical therapy and mobility for critically ill patients in the medical intensive care unit: Beginning experiences in Korea. J Crit Care. 2015;30(4):673-7.⁾ Bourdin et al.,⁽³⁸38 Bourdin G, Barbier J, Burle JF, Durante G, Passant S, Vincent B, et al. The feasibility of early physical activity in intensive care unit patients: a prospective observational one-center study. Respir Care. 2010;55(4):400-7.⁾ Wang et al.,⁽⁴⁸48 Wang YT, Haines TP, Ritchie P, Walker C, Ansell TA, Ryan DT, et al. Early mobilization on continuous renal replacement therapy is safe and may improve filter life. Crit Care. 2014;18(4): R161.⁾ Berney et al.⁽⁴⁹49 Berney S, Haines K, Skinner EH, Denehy L. Safety and feasibility of an exercise prescription approach to rehabilitation across the continuum of care for survivors of critical illness. Phys Ther. 2012;92(12):1524-35.⁾ e Drolet et al.,⁽⁵⁰50 Drolet A, DeJuilio P, Harkless S, Henricks S, Kamin E, Leddy EA, et al. Move to improve: the feasibility of using an early mobility protocol to increase ambulation in the intensive and intermediate care settings. Phys Ther. 2013;93(2):197-207.⁾
	Saturação periférica de oxigênio	> 88%	Pohlman et al.,⁽²2 Pohlman MC, Schweickert WD, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Feasibility of physical and occupational therapy beginning from initiation of mechanical ventilation. Crit Care Med. 2010;38(11):2089-94.⁾ Davis et al.,⁽²⁴24 Davis J, Crawford K, Wierman H, Osgood W, Cavanaugh J, Smith KA, et al. Mobilization of ventilated older adults. J Geriatr Phys Ther. 2013;36(4):162-8.⁾ Perme et al.,⁽¹²12 Perme C, Chandrashekar R. Early mobility and walking program for patients in intensive care units: creating a standard of care. Am J Crit Care. 2009;18(3):212-21.⁾ Needham et al.,⁽¹⁴14 Needham DM, Korupolu R. Rehabilitation quality improvement in an intensive care unit setting: implementation of a quality improvement model. Top Stroke Rehabil. 2010;17(4):271-81.⁾ Schweickert et al.,⁽⁹9 Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009;373(9678):1874-82.⁾ Dong et al.,⁽³²32 Dong ZH, Yu BX, Sun YB, Fang W, Li L. Effects of early rehabilitation therapy on patients with mechanical ventilation. World J Emerg Med. 2014;5(1):48-52.⁾ Brummel et al.,⁽³³33 Brummel NE, Jackson JC, Girard TD, Pandharipande PP, Schiro E, Work B, et al. A combined early cognitive and physical rehabilitation program for people who are critically ill: the activity and cognitive therapy in the intensive care unit (ACT-ICU) trial. Phys Ther. 2012;92(12):1580-92.⁾ Harris et al.,⁽³⁴34 Harris CL, Shahid S. Physical therapy-driven quality improvement to promote early mobility in the intensive care unit. Proc (Bayl Univ Med Cent). 2014;27(3):203-7.⁾ Dammeyer et al.,⁽³⁶36 Dammeyer JA, Baldwin N, Packard D, Harrington S, Christofferson B, Christopher J, et al. Mobilizing outcomes: implementation of a nurse-led multidisciplinary mobility program. Crit Care Nurs Q. 2013;36(1):109-19.⁾ Drolet et al.⁽⁵⁰50 Drolet A, DeJuilio P, Harkless S, Henricks S, Kamin E, Leddy EA, et al. Move to improve: the feasibility of using an early mobility protocol to increase ambulation in the intensive and intermediate care settings. Phys Ther. 2013;93(2):197-207.⁾ e Olkowski et al.⁽⁵¹51 Olkowski BF, Devine MA, Slotnick LE, Veznedaroglu E, Liebman KM, Arcaro ML, et al. Safety and feasibility of an early mobilization program for patients with aneurysmal subarachnoid hemorrhage. Phys Ther. 2013;93(2):208-15.⁾
		≥ 90%	Collings et al.,⁽¹³13 Collings N, Cusack R. A repeated measures, randomised cross-over trial, comparing the acute exercise response between passive and active sitting in critically ill patients. BMC Anesthesiol. 2015;15:1.⁾ Dantas et al.⁽³¹31 Dantas CM, Silva PF, Siqueira FH, Pinto RM, Matias S, Maciel C, et al. Influence of early mobilization on respiratory and peripheral muscle strength in critically ill patients. Rev Bras Ter Intensiva. 2012;24(2):173-8.⁾ e Médrinal et al.⁽²³23 Médrinal C, Lebret M, Bousta M, Nassaj A, Colas G. Effects of sitting at the bedside of the patient with mechanical ventilation. Kinesitherapie Revue. 2013;13(138):43-9.⁾
	Parâmetros da ventilação mecânica	FiO₂ < 0,6 e/ou PEEP < 10cmH₂O	Perme et al.,⁽¹²12 Perme C, Chandrashekar R. Early mobility and walking program for patients in intensive care units: creating a standard of care. Am J Crit Care. 2009;18(3):212-21.⁾ Collings et al.,⁽¹³13 Collings N, Cusack R. A repeated measures, randomised cross-over trial, comparing the acute exercise response between passive and active sitting in critically ill patients. BMC Anesthesiol. 2015;15:1.⁾ Needham et al.,⁽¹⁴14 Needham DM, Korupolu R. Rehabilitation quality improvement in an intensive care unit setting: implementation of a quality improvement model. Top Stroke Rehabil. 2010;17(4):271-81.⁾ Dantas et al.,⁽³¹31 Dantas CM, Silva PF, Siqueira FH, Pinto RM, Matias S, Maciel C, et al. Influence of early mobilization on respiratory and peripheral muscle strength in critically ill patients. Rev Bras Ter Intensiva. 2012;24(2):173-8.⁾ Médrinal et al.,⁽²³23 Médrinal C, Lebret M, Bousta M, Nassaj A, Colas G. Effects of sitting at the bedside of the patient with mechanical ventilation. Kinesitherapie Revue. 2013;13(138):43-9.⁾ Brummel et al.,⁽³³33 Brummel NE, Jackson JC, Girard TD, Pandharipande PP, Schiro E, Work B, et al. A combined early cognitive and physical rehabilitation program for people who are critically ill: the activity and cognitive therapy in the intensive care unit (ACT-ICU) trial. Phys Ther. 2012;92(12):1580-92.⁾ Harris et al.,⁽³⁴34 Harris CL, Shahid S. Physical therapy-driven quality improvement to promote early mobility in the intensive care unit. Proc (Bayl Univ Med Cent). 2014;27(3):203-7.⁾ Perme et al.,⁽³⁵35 Perme C, Nalty T, Winkelman C, Kenji Nawa R, Masud F. Safety and efficacy of mobility interventions in patients with femoral catheters in the ICU: a prospective observational study. Cardiopulm Phys Ther J. 2013;24(2):12-7.⁾ Timmerman,⁽³⁷37 Timmerman RA. A mobility protocol for critically ill adults. Dimens Crit Care Nurs. 2007;26(5):175-9; quiz 180-1.⁾ Lee et al.,⁽²⁵25 Lee H, Ko YJ, Suh GY, Yang JH, Park CM, Jeon K, et al. Safety profile and feasibility of early physical therapy and mobility for critically ill patients in the medical intensive care unit: Beginning experiences in Korea. J Crit Care. 2015;30(4):673-7.⁾ Segers et al.,⁽³⁹39 Segers J, Hermans G, Bruyninckx F, Meyfroidt G, Langer D, Gosselink R. Feasibility of neuromuscular electrical stimulation in critically ill patients. J Crit Care. 2014;29(6):1082-8.⁾ Balas et al.,⁽⁴⁷47 Balas MC, Vasilevskis EE, Olsen KM, Schmid KK, Shostrom V, Cohen MZ, et al. Effectiveness and safety of the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle. Crit Care Med. 2014;42(5):1024-36.⁾ Wang et al.⁽⁴⁸48 Wang YT, Haines TP, Ritchie P, Walker C, Ansell TA, Ryan DT, et al. Early mobilization on continuous renal replacement therapy is safe and may improve filter life. Crit Care. 2014;18(4): R161.⁾ e Drolet et al.⁽⁵⁰50 Drolet A, DeJuilio P, Harkless S, Henricks S, Kamin E, Leddy EA, et al. Move to improve: the feasibility of using an early mobility protocol to increase ambulation in the intensive and intermediate care settings. Phys Ther. 2013;93(2):197-207.⁾
		FiO₂ ≤ 0,6 e PEEP ≤ 10cmH₂O	Davis et al.,⁽²⁴24 Davis J, Crawford K, Wierman H, Osgood W, Cavanaugh J, Smith KA, et al. Mobilization of ventilated older adults. J Geriatr Phys Ther. 2013;36(4):162-8.⁾ Mah et al.,⁽⁴¹41 Mah JW, Staff I, Fichandler D, Butler KL. Resource-efficient mobilization programs in the intensive care unit: who stands to win? Am J Surg. 2013;206(4):488-93.⁾ Dickinson et al.,⁽⁴²42 Dickinson S, Tschannen D, Shever LL. Can the use of an early mobility program reduce the incidence of pressure ulcers in a surgical critical care unit? Crit Care Nurs Q. 2013;36(1):127-40.⁾ Thomsen et al.,⁽⁴⁵45 Thomsen GE, Snow GL, Rodriguez L, Hopkins RO. Patients with respiratory failure increase ambulation after transfer to an intensive care unit where early activity is a priority. Crit Care Med. 2008;36(4):1119-24.⁾ Bailey et al.⁽¹⁰10 Bailey P, Thomsen GE, Spuhler VJ, Blair R, Jewkes J, Bezdjian L, et al. Early activity is feasible and safe in respiratory failure patients. Crit Care Med. 2007;35(1):139-45.⁾ e Needham et al.⁽⁴⁶46 Needham DM, Korupolu R, Zanni JM, Pradhan P, Colantuoni E, Palmer JB, et al. Early physical medicine and rehabilitation for patients with acute respiratory failure: a quality improvement project. Arch Phys Med Rehabil. 2010;91(4):536-42.⁾
	Proteger vias aéreas	-	Pohlman et al.,⁽²2 Pohlman MC, Schweickert WD, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Feasibility of physical and occupational therapy beginning from initiation of mechanical ventilation. Crit Care Med. 2010;38(11):2089-94.⁾ Schweickert et al.,⁽⁹9 Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009;373(9678):1874-82.⁾ Brummel et al.⁽³³33 Brummel NE, Jackson JC, Girard TD, Pandharipande PP, Schiro E, Work B, et al. A combined early cognitive and physical rehabilitation program for people who are critically ill: the activity and cognitive therapy in the intensive care unit (ACT-ICU) trial. Phys Ther. 2012;92(12):1580-92.⁾ e Dammeyer et al.⁽³⁶36 Dammeyer JA, Baldwin N, Packard D, Harrington S, Christofferson B, Christopher J, et al. Mobilizing outcomes: implementation of a nurse-led multidisciplinary mobility program. Crit Care Nurs Q. 2013;36(1):109-19.⁾
Neurológicos	Pressão intracraniana	Não elevada	Pohlman et al.,⁽²2 Pohlman MC, Schweickert WD, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Feasibility of physical and occupational therapy beginning from initiation of mechanical ventilation. Crit Care Med. 2010;38(11):2089-94.⁾ Schweickert et al.,⁽⁹9 Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009;373(9678):1874-82.⁾ Dantas et al.,⁽³¹31 Dantas CM, Silva PF, Siqueira FH, Pinto RM, Matias S, Maciel C, et al. Influence of early mobilization on respiratory and peripheral muscle strength in critically ill patients. Rev Bras Ter Intensiva. 2012;24(2):173-8.⁾ Brummel et al.,⁽³³33 Brummel NE, Jackson JC, Girard TD, Pandharipande PP, Schiro E, Work B, et al. A combined early cognitive and physical rehabilitation program for people who are critically ill: the activity and cognitive therapy in the intensive care unit (ACT-ICU) trial. Phys Ther. 2012;92(12):1580-92.⁾ Dammeyer et al.,⁽³⁶36 Dammeyer JA, Baldwin N, Packard D, Harrington S, Christofferson B, Christopher J, et al. Mobilizing outcomes: implementation of a nurse-led multidisciplinary mobility program. Crit Care Nurs Q. 2013;36(1):109-19.⁾ Titsworth et al.⁽⁴³43 Titsworth WL, Hester J, Correia T, Reed R, Guin P, Archibald L, et al. The effect of increased mobility on morbidity in the neurointensive care unit. J Neurosurg. 2012;116(6):1379-88.⁾ e Meyer et al.⁽⁵³53 Meyer MJ, Stanislaus AB, Lee J, Waak K, Ryan C, Saxena R, et al. Surgical Intensive Care Unit Optimal Mobilisation Score (SOMS) trial: a protocol for an international, multicentre, randomised controlled trial focused on goal-directed early mobilisation of surgical ICU patients. BMJ Open. 2013;3(8):e003262.⁾
	Nível de consciência	Ausência de coma	Davis et al.,⁽²⁴24 Davis J, Crawford K, Wierman H, Osgood W, Cavanaugh J, Smith KA, et al. Mobilization of ventilated older adults. J Geriatr Phys Ther. 2013;36(4):162-8.⁾ Thomsen et al.,⁽⁴⁵45 Thomsen GE, Snow GL, Rodriguez L, Hopkins RO. Patients with respiratory failure increase ambulation after transfer to an intensive care unit where early activity is a priority. Crit Care Med. 2008;36(4):1119-24.⁾ Bailey et al.⁽¹⁰10 Bailey P, Thomsen GE, Spuhler VJ, Blair R, Jewkes J, Bezdjian L, et al. Early activity is feasible and safe in respiratory failure patients. Crit Care Med. 2007;35(1):139-45.⁾ e Witcher et al.⁽⁵²52 Witcher R, Stoerger L, Dzierba AL, Silverstein A, Rosengart A, Brodie D, et al. Effect of early mobilization on sedation practices in the neurosciences intensive care unit: a preimplementation and postimplementation evaluation. J Crit Care. 2015;30(2):344-7.⁾
		Ausência de agitação	Médrinal et al.,⁽²³23 Médrinal C, Lebret M, Bousta M, Nassaj A, Colas G. Effects of sitting at the bedside of the patient with mechanical ventilation. Kinesitherapie Revue. 2013;13(138):43-9.⁾ Harris et al.,⁽³⁴34 Harris CL, Shahid S. Physical therapy-driven quality improvement to promote early mobility in the intensive care unit. Proc (Bayl Univ Med Cent). 2014;27(3):203-7.⁾ Bourdin et al.⁽³⁸38 Bourdin G, Barbier J, Burle JF, Durante G, Passant S, Vincent B, et al. The feasibility of early physical activity in intensive care unit patients: a prospective observational one-center study. Respir Care. 2010;55(4):400-7.⁾ e Segers et al.⁽³⁹39 Segers J, Hermans G, Bruyninckx F, Meyfroidt G, Langer D, Gosselink R. Feasibility of neuromuscular electrical stimulation in critically ill patients. J Crit Care. 2014;29(6):1082-8.⁾
		Entender e cumprir comandos apropriadamente	Nava,⁽³⁰30 Nava S. Rehabilitation of patients admitted to a respiratory intensive care unit. Arch Phys Med Rehabil. 1998;79(7):849-54.⁾ Perme et al.,⁽³⁵35 Perme C, Nalty T, Winkelman C, Kenji Nawa R, Masud F. Safety and efficacy of mobility interventions in patients with femoral catheters in the ICU: a prospective observational study. Cardiopulm Phys Ther J. 2013;24(2):12-7.⁾ Bourdin et al.,⁽³⁸38 Bourdin G, Barbier J, Burle JF, Durante G, Passant S, Vincent B, et al. The feasibility of early physical activity in intensive care unit patients: a prospective observational one-center study. Respir Care. 2010;55(4):400-7.⁾ Thomsen et al.⁽⁴⁵45 Thomsen GE, Snow GL, Rodriguez L, Hopkins RO. Patients with respiratory failure increase ambulation after transfer to an intensive care unit where early activity is a priority. Crit Care Med. 2008;36(4):1119-24.⁾ e Wang et al.⁽⁴⁸48 Wang YT, Haines TP, Ritchie P, Walker C, Ansell TA, Ryan DT, et al. Early mobilization on continuous renal replacement therapy is safe and may improve filter life. Crit Care. 2014;18(4): R161.⁾
		Abertura ocular ao estímulo verbal	Davis et al.,⁽²⁴24 Davis J, Crawford K, Wierman H, Osgood W, Cavanaugh J, Smith KA, et al. Mobilization of ventilated older adults. J Geriatr Phys Ther. 2013;36(4):162-8.⁾ Needham et al.,⁽¹⁴14 Needham DM, Korupolu R. Rehabilitation quality improvement in an intensive care unit setting: implementation of a quality improvement model. Top Stroke Rehabil. 2010;17(4):271-81.⁾ Olkowski et al.⁽⁵¹51 Olkowski BF, Devine MA, Slotnick LE, Veznedaroglu E, Liebman KM, Arcaro ML, et al. Safety and feasibility of an early mobilization program for patients with aneurysmal subarachnoid hemorrhage. Phys Ther. 2013;93(2):208-15.⁾ e Engel et al.⁽⁴⁰40 Engel HJ, Tatebe S, Alonzo PB, Mustille RL, Rivera MJ. Physical therapist-established intensive care unit early mobilization program: quality improvement project for critical care at the University of California San Francisco Medical Center. Phys Ther. 2013;93(7):975-85.⁾
		Responder ao estímulo verbal	Collings et al.,⁽¹³13 Collings N, Cusack R. A repeated measures, randomised cross-over trial, comparing the acute exercise response between passive and active sitting in critically ill patients. BMC Anesthesiol. 2015;15:1.⁾ Mah et al.⁽⁴¹41 Mah JW, Staff I, Fichandler D, Butler KL. Resource-efficient mobilization programs in the intensive care unit: who stands to win? Am J Surg. 2013;206(4):488-93.⁾ e Bailey et al.⁽¹⁰10 Bailey P, Thomsen GE, Spuhler VJ, Blair R, Jewkes J, Bezdjian L, et al. Early activity is feasible and safe in respiratory failure patients. Crit Care Med. 2007;35(1):139-45.⁾
	Ausência de diagnóstico de doenças neurológicas e/ou neuromuscular que impeçam a realização da mobilização	--	Pohlman et al.,⁽²2 Pohlman MC, Schweickert WD, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Feasibility of physical and occupational therapy beginning from initiation of mechanical ventilation. Crit Care Med. 2010;38(11):2089-94.⁾ Dantas et al.,⁽³¹31 Dantas CM, Silva PF, Siqueira FH, Pinto RM, Matias S, Maciel C, et al. Influence of early mobilization on respiratory and peripheral muscle strength in critically ill patients. Rev Bras Ter Intensiva. 2012;24(2):173-8.⁾ Segers et al.,⁽³⁹39 Segers J, Hermans G, Bruyninckx F, Meyfroidt G, Langer D, Gosselink R. Feasibility of neuromuscular electrical stimulation in critically ill patients. J Crit Care. 2014;29(6):1082-8.⁾ Engel et al.,⁽⁴⁰40 Engel HJ, Tatebe S, Alonzo PB, Mustille RL, Rivera MJ. Physical therapist-established intensive care unit early mobilization program: quality improvement project for critical care at the University of California San Francisco Medical Center. Phys Ther. 2013;93(7):975-85.⁾ Ronnebaum et al.,⁽⁴⁴44 Ronnebaum JA, Weir JP, Hilsabeck TA. Earlier mobilization decreases the length of stay in the intensive care unit. J Acute Care Phys Ther. 2012;3(2):204-10.⁾ Meyer et al.⁽⁵³53 Meyer MJ, Stanislaus AB, Lee J, Waak K, Ryan C, Saxena R, et al. Surgical Intensive Care Unit Optimal Mobilisation Score (SOMS) trial: a protocol for an international, multicentre, randomised controlled trial focused on goal-directed early mobilisation of surgical ICU patients. BMJ Open. 2013;3(8):e003262.⁾ Winkelman et al.⁽⁵⁴54 Winkelman C, Higgins PA, Chen YJ. Activity in the chronically critically ill. Dimens Crit Care Nurs. 2005;24(6):281-90.⁾ e Hopkins et al.⁽⁵⁵55 Hopkins RO, Miller RR 3rd, Rodriguez L, Spuhler V, Thomsen GE. Physical therapy on the wards after early physical activity and mobility in the intensive care unit. Phys Ther. 2012;92(12):1518-23.⁾
Ortopédicos	Ausência de fraturas instáveis	--	Clark et al.,⁽¹¹11 Clark DE, Lowman JD, Griffin RL, Matthews HM, Reiff DA. Effectiveness of an early mobilization protocol in a trauma and burns intensive care unit: a retrospective cohort study. Phys Ther. 2013;93(2):186-96.⁾ Dantas et al.,⁽³¹31 Dantas CM, Silva PF, Siqueira FH, Pinto RM, Matias S, Maciel C, et al. Influence of early mobilization on respiratory and peripheral muscle strength in critically ill patients. Rev Bras Ter Intensiva. 2012;24(2):173-8.⁾ Timmerman,⁽³⁷37 Timmerman RA. A mobility protocol for critically ill adults. Dimens Crit Care Nurs. 2007;26(5):175-9; quiz 180-1.⁾ Engel et al.⁽⁴⁰40 Engel HJ, Tatebe S, Alonzo PB, Mustille RL, Rivera MJ. Physical therapist-established intensive care unit early mobilization program: quality improvement project for critical care at the University of California San Francisco Medical Center. Phys Ther. 2013;93(7):975-85.⁾ e Meyer et al.⁽⁵³53 Meyer MJ, Stanislaus AB, Lee J, Waak K, Ryan C, Saxena R, et al. Surgical Intensive Care Unit Optimal Mobilisation Score (SOMS) trial: a protocol for an international, multicentre, randomised controlled trial focused on goal-directed early mobilisation of surgical ICU patients. BMJ Open. 2013;3(8):e003262.⁾
	Ausência de instabilidade óssea	--	Clark et al.,⁽¹¹11 Clark DE, Lowman JD, Griffin RL, Matthews HM, Reiff DA. Effectiveness of an early mobilization protocol in a trauma and burns intensive care unit: a retrospective cohort study. Phys Ther. 2013;93(2):186-96.⁾ Titsworth et al.⁽⁴³43 Titsworth WL, Hester J, Correia T, Reed R, Guin P, Archibald L, et al. The effect of increased mobility on morbidity in the neurointensive care unit. J Neurosurg. 2012;116(6):1379-88.⁾ e Witcher et al.⁽⁵²52 Witcher R, Stoerger L, Dzierba AL, Silverstein A, Rosengart A, Brodie D, et al. Effect of early mobilization on sedation practices in the neurosciences intensive care unit: a preimplementation and postimplementation evaluation. J Crit Care. 2015;30(2):344-7.⁾
	Ausência de contraindicações ortopédicas que impossibilitem a mobilização	--	Collings et al.,⁽¹³13 Collings N, Cusack R. A repeated measures, randomised cross-over trial, comparing the acute exercise response between passive and active sitting in critically ill patients. BMC Anesthesiol. 2015;15:1.⁾ Nava⁽³⁰30 Nava S. Rehabilitation of patients admitted to a respiratory intensive care unit. Arch Phys Med Rehabil. 1998;79(7):849-54.⁾ e Drolet et al.⁽⁵⁰50 Drolet A, DeJuilio P, Harkless S, Henricks S, Kamin E, Leddy EA, et al. Move to improve: the feasibility of using an early mobility protocol to increase ambulation in the intensive and intermediate care settings. Phys Ther. 2013;93(2):197-207.⁾
Outros	Ausência de BNM	--	Abrams et al.,⁽²¹21 Abrams D, Javidfar J, Farrand E, Mongero LB, Agerstrand CL, Ryan P, et al. Early mobilization of patients receiving extracorporeal membrane oxygenation: a retrospective cohort study. Crit Care. 2014;18(1):R38.⁾ Timmerman,⁽³⁷37 Timmerman RA. A mobility protocol for critically ill adults. Dimens Crit Care Nurs. 2007;26(5):175-9; quiz 180-1.⁾ Segers et al.⁽³⁹39 Segers J, Hermans G, Bruyninckx F, Meyfroidt G, Langer D, Gosselink R. Feasibility of neuromuscular electrical stimulation in critically ill patients. J Crit Care. 2014;29(6):1082-8.⁾ e Witcher et al.⁽⁵²52 Witcher R, Stoerger L, Dzierba AL, Silverstein A, Rosengart A, Brodie D, et al. Effect of early mobilization on sedation practices in the neurosciences intensive care unit: a preimplementation and postimplementation evaluation. J Crit Care. 2015;30(2):344-7.⁾
	Ausência de peritoniostomia	--	Clark et al.,⁽¹¹11 Clark DE, Lowman JD, Griffin RL, Matthews HM, Reiff DA. Effectiveness of an early mobilization protocol in a trauma and burns intensive care unit: a retrospective cohort study. Phys Ther. 2013;93(2):186-96.⁾ Engel et al.,⁽⁴⁰40 Engel HJ, Tatebe S, Alonzo PB, Mustille RL, Rivera MJ. Physical therapist-established intensive care unit early mobilization program: quality improvement project for critical care at the University of California San Francisco Medical Center. Phys Ther. 2013;93(7):975-85.⁾ Balas et al.⁽⁴⁷47 Balas MC, Vasilevskis EE, Olsen KM, Schmid KK, Shostrom V, Cohen MZ, et al. Effectiveness and safety of the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle. Crit Care Med. 2014;42(5):1024-36.⁾ e Hopkins et al.⁽⁵⁵55 Hopkins RO, Miller RR 3rd, Rodriguez L, Spuhler V, Thomsen GE. Physical therapy on the wards after early physical activity and mobility in the intensive care unit. Phys Ther. 2012;92(12):1518-23.⁾
	Não estar em cuidados paliativos	--	Pohlman et al.,⁽²2 Pohlman MC, Schweickert WD, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Feasibility of physical and occupational therapy beginning from initiation of mechanical ventilation. Crit Care Med. 2010;38(11):2089-94.⁾ Médrinal et al.,⁽²³23 Médrinal C, Lebret M, Bousta M, Nassaj A, Colas G. Effects of sitting at the bedside of the patient with mechanical ventilation. Kinesitherapie Revue. 2013;13(138):43-9.⁾ Segers et al.,⁽³⁹39 Segers J, Hermans G, Bruyninckx F, Meyfroidt G, Langer D, Gosselink R. Feasibility of neuromuscular electrical stimulation in critically ill patients. J Crit Care. 2014;29(6):1082-8.⁾ Engel et al.,⁽⁴⁰40 Engel HJ, Tatebe S, Alonzo PB, Mustille RL, Rivera MJ. Physical therapist-established intensive care unit early mobilization program: quality improvement project for critical care at the University of California San Francisco Medical Center. Phys Ther. 2013;93(7):975-85.⁾ Titsworth et al.,⁽⁴³43 Titsworth WL, Hester J, Correia T, Reed R, Guin P, Archibald L, et al. The effect of increased mobility on morbidity in the neurointensive care unit. J Neurosurg. 2012;116(6):1379-88.⁾ Meyer et al.⁽⁵³53 Meyer MJ, Stanislaus AB, Lee J, Waak K, Ryan C, Saxena R, et al. Surgical Intensive Care Unit Optimal Mobilisation Score (SOMS) trial: a protocol for an international, multicentre, randomised controlled trial focused on goal-directed early mobilisation of surgical ICU patients. BMJ Open. 2013;3(8):e003262.⁾ e Hopkins et al.⁽⁵⁵55 Hopkins RO, Miller RR 3rd, Rodriguez L, Spuhler V, Thomsen GE. Physical therapy on the wards after early physical activity and mobility in the intensive care unit. Phys Ther. 2012;92(12):1518-23.⁾
	Ausência de trombose venosa profunda	--	Collings et al.,⁽¹³13 Collings N, Cusack R. A repeated measures, randomised cross-over trial, comparing the acute exercise response between passive and active sitting in critically ill patients. BMC Anesthesiol. 2015;15:1.⁾ Needham et al.,⁽¹⁴14 Needham DM, Korupolu R. Rehabilitation quality improvement in an intensive care unit setting: implementation of a quality improvement model. Top Stroke Rehabil. 2010;17(4):271-81.⁾ Lee et al.⁽²⁵25 Lee H, Ko YJ, Suh GY, Yang JH, Park CM, Jeon K, et al. Safety profile and feasibility of early physical therapy and mobility for critically ill patients in the medical intensive care unit: Beginning experiences in Korea. J Crit Care. 2015;30(4):673-7.⁾ e Drolet et al.⁽⁵⁰50 Drolet A, DeJuilio P, Harkless S, Henricks S, Kamin E, Leddy EA, et al. Move to improve: the feasibility of using an early mobility protocol to increase ambulation in the intensive and intermediate care settings. Phys Ther. 2013;93(2):197-207.⁾
	Não estar em hemodiálise contínua	--	Schweickert et al.,⁽⁹9 Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009;373(9678):1874-82.⁾ Dammeyer et al.,⁽³⁶36 Dammeyer JA, Baldwin N, Packard D, Harrington S, Christofferson B, Christopher J, et al. Mobilizing outcomes: implementation of a nurse-led multidisciplinary mobility program. Crit Care Nurs Q. 2013;36(1):109-19.⁾ Bourdin et al.⁽³⁸38 Bourdin G, Barbier J, Burle JF, Durante G, Passant S, Vincent B, et al. The feasibility of early physical activity in intensive care unit patients: a prospective observational one-center study. Respir Care. 2010;55(4):400-7.⁾ e Titsworth et al.⁽⁴³43 Titsworth WL, Hester J, Correia T, Reed R, Guin P, Archibald L, et al. The effect of increased mobility on morbidity in the neurointensive care unit. J Neurosurg. 2012;116(6):1379-88.⁾
	Temperatura corporal	< 38,5°	Collings et al.,⁽¹³13 Collings N, Cusack R. A repeated measures, randomised cross-over trial, comparing the acute exercise response between passive and active sitting in critically ill patients. BMC Anesthesiol. 2015;15:1.⁾ Segers et al.,⁽³⁹39 Segers J, Hermans G, Bruyninckx F, Meyfroidt G, Langer D, Gosselink R. Feasibility of neuromuscular electrical stimulation in critically ill patients. J Crit Care. 2014;29(6):1082-8.⁾ Wang et al.⁽⁴⁸48 Wang YT, Haines TP, Ritchie P, Walker C, Ansell TA, Ryan DT, et al. Early mobilization on continuous renal replacement therapy is safe and may improve filter life. Crit Care. 2014;18(4): R161.⁾ e Berney et al.⁽⁴⁹49 Berney S, Haines K, Skinner EH, Denehy L. Safety and feasibility of an exercise prescription approach to rehabilitation across the continuum of care for survivors of critical illness. Phys Ther. 2012;92(12):1524-35.⁾
	Ausência de hemorragia gastrintestinal ativa	--	Pohlman et al.,⁽²2 Pohlman MC, Schweickert WD, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Feasibility of physical and occupational therapy beginning from initiation of mechanical ventilation. Crit Care Med. 2010;38(11):2089-94.⁾ Schweickert et al.,⁽⁹9 Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009;373(9678):1874-82.⁾ Brummel et al.⁽³³33 Brummel NE, Jackson JC, Girard TD, Pandharipande PP, Schiro E, Work B, et al. A combined early cognitive and physical rehabilitation program for people who are critically ill: the activity and cognitive therapy in the intensive care unit (ACT-ICU) trial. Phys Ther. 2012;92(12):1580-92.⁾ e Dammeyer et al.⁽³⁶36 Dammeyer JA, Baldwin N, Packard D, Harrington S, Christofferson B, Christopher J, et al. Mobilizing outcomes: implementation of a nurse-led multidisciplinary mobility program. Crit Care Nurs Q. 2013;36(1):109-19.⁾
	Ausência de hemorragia ativa	--	Abrams et al.,⁽²¹21 Abrams D, Javidfar J, Farrand E, Mongero LB, Agerstrand CL, Ryan P, et al. Early mobilization of patients receiving extracorporeal membrane oxygenation: a retrospective cohort study. Crit Care. 2014;18(1):R38.⁾ Timmerman,⁽³⁷37 Timmerman RA. A mobility protocol for critically ill adults. Dimens Crit Care Nurs. 2007;26(5):175-9; quiz 180-1.⁾ Lee et al.⁽²⁵25 Lee H, Ko YJ, Suh GY, Yang JH, Park CM, Jeon K, et al. Safety profile and feasibility of early physical therapy and mobility for critically ill patients in the medical intensive care unit: Beginning experiences in Korea. J Crit Care. 2015;30(4):673-7.⁾ e Engel et al.⁽⁴⁰40 Engel HJ, Tatebe S, Alonzo PB, Mustille RL, Rivera MJ. Physical therapist-established intensive care unit early mobilization program: quality improvement project for critical care at the University of California San Francisco Medical Center. Phys Ther. 2013;93(7):975-85.⁾

Tipo de estudo	Referência	País	N	Tipo de UTI	Protocolo de mobilização	Eventos adversos
Ensaio clínico randomizado	Collings et al.⁽¹³13 Collings N, Cusack R. A repeated measures, randomised cross-over trial, comparing the acute exercise response between passive and active sitting in critically ill patients. BMC Anesthesiol. 2015;15:1.⁾	Reino Unido	11	Geral	Sentar à beira leito e tranferência passiva para a cadeira	Dois EA: dessaturação devido à condensação no circuito do ventilador (1) e aumento da FC além de 80% do limite máximo da FC pré-mobilização (1)
Ensaio clínico randomizado	Schweickert et al.⁽⁹9 Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009;373(9678):1874-82.⁾	Estados Unidos	104	Clínica	Mobilização passiva, ativo-assitida, ativa, sedestação à beira do leito, treino de Atividades de Vida Diária, transferências, ortostatismo, deambulação	Dois EA: dessaturação menor que 80% e perda de cateter da artéria radial
Ensaio clínico randomizado	Dong et al.⁽³²32 Dong ZH, Yu BX, Sun YB, Fang W, Li L. Effects of early rehabilitation therapy on patients with mechanical ventilation. World J Emerg Med. 2014;5(1):48-52.⁾	China	60	Geral	Mobilização ativa, sedestação à beira leito, transferências, ortostatismo e deambulação	Um EA: hipotensão postural
Ensaio clínico randomizado	Médrinal et al.⁽²³23 Médrinal C, Lebret M, Bousta M, Nassaj A, Colas G. Effects of sitting at the bedside of the patient with mechanical ventilation. Kinesitherapie Revue. 2013;13(138):43-9.⁾	França	12	Geral	Mobilização passiva e sedestação à beira do leito	EA em menos de 3% das intervenções
Ensaio clínico randomizado	Dantas et al.⁽³¹31 Dantas CM, Silva PF, Siqueira FH, Pinto RM, Matias S, Maciel C, et al. Influence of early mobilization on respiratory and peripheral muscle strength in critically ill patients. Rev Bras Ter Intensiva. 2012;24(2):173-8.⁾	Brasil	59	Geral	Posicionamento, alongamentos, mobilização passiva, exercícios ativo-assistidos, sedestação à beira do leito, exercícios resistidos, cicloergômetro, transferências, treino de equilíbrio e deambulação	Não relatado
Ensaio clínico randomizado	Nava⁽³⁰30 Nava S. Rehabilitation of patients admitted to a respiratory intensive care unit. Arch Phys Med Rehabil. 1998;79(7):849-54.⁾	Itália	80	Respiratória	Mobilização passiva e ativa, sedestação à beira do leito, transferências, exercícios específicos para o treino da musculatura respiratória, cicloergômetro e deambulação	Não relatado
Estudo prospectivo	Balas et al.⁽⁴⁷47 Balas MC, Vasilevskis EE, Olsen KM, Schmid KK, Shostrom V, Cohen MZ, et al. Effectiveness and safety of the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle. Crit Care Med. 2014;42(5):1024-36.⁾	Estados Unidos	296	Geral	Sem protocolo. Foi observado se os pacientes realizavam a fisioterapia diariamente e se foram mobilizados fora do leito	Sete extubações não planejadas (p = 0,98)
Estudo parte prospectivo, parte retrospectivo	Needham et al.⁽¹⁴14 Needham DM, Korupolu R. Rehabilitation quality improvement in an intensive care unit setting: implementation of a quality improvement model. Top Stroke Rehabil. 2010;17(4):271-81.⁾	Estados Unidos	57	Clínica	Transferências, sedestação à beira do leito, ortostatismo e deambulação	Quatro EA. Não caracterizado
Estudo retrospectivo	Dickinson et al.⁽⁴²42 Dickinson S, Tschannen D, Shever LL. Can the use of an early mobility program reduce the incidence of pressure ulcers in a surgical critical care unit? Crit Care Nurs Q. 2013;36(1):127-40.⁾	Estados Unidos	1.112	Cirúrgica	Mobilização passiva e ativa, posicionamentos, sentar à beira leito, ortostatismo, transferência para cadeira e deambular com ou sem assistência	Não relatado
Estudo retrospectivo	Ronnebaum et al.⁽⁴⁴44 Ronnebaum JA, Weir JP, Hilsabeck TA. Earlier mobilization decreases the length of stay in the intensive care unit. J Acute Care Phys Ther. 2012;3(2):204-10.⁾	Estados Unidos	28	Geral	Mobilização passiva e ativa no leito, alongamentos, transferências, treino de marcha	Não ocorreram
Estudo retrospectivo	Abrams et al.⁽²¹21 Abrams D, Javidfar J, Farrand E, Mongero LB, Agerstrand CL, Ryan P, et al. Early mobilization of patients receiving extracorporeal membrane oxygenation: a retrospective cohort study. Crit Care. 2014;18(1):R38.⁾	Estados Unidos	35	Clínica	Mobilização passiva e ativo-assistida no leito, posicionamento, sedestação à beira leito, transferências, ortostatismo, marcha estacionária e deambulação	Não relatado
Estudo retrospectivo	Witcher et al.⁽⁵²52 Witcher R, Stoerger L, Dzierba AL, Silverstein A, Rosengart A, Brodie D, et al. Effect of early mobilization on sedation practices in the neurosciences intensive care unit: a preimplementation and postimplementation evaluation. J Crit Care. 2015;30(2):344-7.⁾	Estados Unidos	68	Neurológica	Mobilização passiva e ativa, sedestação à beira do leito, ortostatismo e deambulação	Não relatado
Estudo retrospectivo	Clark et al.⁽¹¹11 Clark DE, Lowman JD, Griffin RL, Matthews HM, Reiff DA. Effectiveness of an early mobilization protocol in a trauma and burns intensive care unit: a retrospective cohort study. Phys Ther. 2013;93(2):186-96.⁾	Estados Unidos	2.176	Trauma e queimados	Mobilização passiva, sedestação à beira do leito, exercícios ativos, transferências, deambulação	Não ocorreram
Estudo retrospectivo	Olkowski et al.⁽⁵¹51 Olkowski BF, Devine MA, Slotnick LE, Veznedaroglu E, Liebman KM, Arcaro ML, et al. Safety and feasibility of an early mobilization program for patients with aneurysmal subarachnoid hemorrhage. Phys Ther. 2013;93(2):208-15.⁾	Estados Unidos	25	Neurocirúrgica	Posicionamentos, programa educacional, treinamento funcional e exercícios terapêuticos	EA em 5,9% das sessões. PAM < 70mmHg (9 pacientes), PAM > 120mmHg (7 pacientes) e paciente FC > 130bpm (1 paciente)
Estudo retrospectivo	Lee et al.⁽²⁵25 Lee H, Ko YJ, Suh GY, Yang JH, Park CM, Jeon K, et al. Safety profile and feasibility of early physical therapy and mobility for critically ill patients in the medical intensive care unit: Beginning experiences in Korea. J Crit Care. 2015;30(4):673-7.⁾	Coreia	99	Clínica	Estimulação elétrica neuromuscular, mobilização passiva e ativa, mobilização no leito, transferências, ortostatismo, exercícios terapêuticos e deambulação	26 potenciais EA (5,0%; IC95%, 3,4% - 7,3%) observados em 17 pacientes (17,2%; IC95%, 10,6% - 26,4%). O uso de ECMO foi um fator independente associado com EA com OR de 5,8 (IC95%, 2,2 - 15,6; p < ,001)
Estudo retrospectivo	Engel et al.⁽⁴⁰40 Engel HJ, Tatebe S, Alonzo PB, Mustille RL, Rivera MJ. Physical therapist-established intensive care unit early mobilization program: quality improvement project for critical care at the University of California San Francisco Medical Center. Phys Ther. 2013;93(7):975-85.⁾	Estados Unidos	294	Geral	Mobilização, ortostatismo, transferência para a cadeira, treino de marcha	Remoção acidental de dispositivos. Não foi quantificado
Série de casos	Winkelman et al.⁽⁵⁴54 Winkelman C, Higgins PA, Chen YJ. Activity in the chronically critically ill. Dimens Crit Care Nurs. 2005;24(6):281-90.⁾	Estados Unidos	19	Geral	Sem protocolo específico. Foi considerado como atividade terapêutica a mobilização passiva, sentar fora do leito e deambulação	Não relatado
Série de casos	Segers et al.⁽³⁹39 Segers J, Hermans G, Bruyninckx F, Meyfroidt G, Langer D, Gosselink R. Feasibility of neuromuscular electrical stimulation in critically ill patients. J Crit Care. 2014;29(6):1082-8.⁾	Bélgica	50	Geral	Estimulação elétrica neuromuscular	Não ocorreram
Série de casos	Pohlman et al.⁽²2 Pohlman MC, Schweickert WD, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Feasibility of physical and occupational therapy beginning from initiation of mechanical ventilation. Crit Care Med. 2010;38(11):2089-94.⁾	Estados Unidos	49	Geral	Mobilização passiva, ativo-assitida e ativa, sedestação à beira do leito, treino de equilíbrio, ortostatismo, marcha estacionária e deambulação	EA em 16% das sessões (80 de 498). Dessaturação (6%), aumento maior que 20% na FC (4,2%), assincronia/taquipneia (4%), agitação/desconforto (2%), perda de dispositivos (0,8%)
Série de casos	Drolet et al.⁽⁵⁰50 Drolet A, DeJuilio P, Harkless S, Henricks S, Kamin E, Leddy EA, et al. Move to improve: the feasibility of using an early mobility protocol to increase ambulation in the intensive and intermediate care settings. Phys Ther. 2013;93(2):197-207.⁾	Estados Unidos	426	Geral	Programa educacional, deambular com ou sem assistência	Não relatado
Série de casos	Davis et al.⁽²⁴24 Davis J, Crawford K, Wierman H, Osgood W, Cavanaugh J, Smith KA, et al. Mobilization of ventilated older adults. J Geriatr Phys Ther. 2013;36(4):162-8.⁾	Estados Unidos	230	Geral	Programa educacional, posicionamento no leito, treino de mobilização no leito, transferências e exercícios terapêuticos	Um EA em 171 sessões: hipotensão postural
Série de casos	Thomsen et al.⁽⁴⁵45 Thomsen GE, Snow GL, Rodriguez L, Hopkins RO. Patients with respiratory failure increase ambulation after transfer to an intensive care unit where early activity is a priority. Crit Care Med. 2008;36(4):1119-24.⁾	Estados Unidos	104	Respiratória	Sedestação à beira do leito, transferência para a cadeira, atividades funcionais e deambular com andador e/ou com ou sem auxílio extra	Não relatado
Série de casos	Hopkins et al.⁽⁵⁵55 Hopkins RO, Miller RR 3rd, Rodriguez L, Spuhler V, Thomsen GE. Physical therapy on the wards after early physical activity and mobility in the intensive care unit. Phys Ther. 2012;92(12):1518-23.⁾	Estados Unidos	72	Respiratória	Mobilização passiva e ativa, sedestação à beira do leito, transferências e deambulação	Não relatado
Série de casos	Harris et al.⁽³⁴34 Harris CL, Shahid S. Physical therapy-driven quality improvement to promote early mobility in the intensive care unit. Proc (Bayl Univ Med Cent). 2014;27(3):203-7.⁾	Estados Unidos	21	Cardiológica	Mobilização passiva e ativa, sedestação à beira do leito, transferências e deambulação	Não relatado
Série de casos	Perme et al.⁽³⁵35 Perme C, Nalty T, Winkelman C, Kenji Nawa R, Masud F. Safety and efficacy of mobility interventions in patients with femoral catheters in the ICU: a prospective observational study. Cardiopulm Phys Ther J. 2013;24(2):12-7.⁾	Estados Unidos	77	Cardiovascular	Sedestação à beira do leito, transferência para a cadeira e deambulação	Não ocorreram
Série de casos	Titsworth et al.⁽⁴³43 Titsworth WL, Hester J, Correia T, Reed R, Guin P, Archibald L, et al. The effect of increased mobility on morbidity in the neurointensive care unit. J Neurosurg. 2012;116(6):1379-88.⁾	Estados Unidos	170	Clínica	Posicionamento, mobilização passiva e ativa, sedestação à beira do leito, transferências, ortostatismo e deambulação	Não ocorreram
Estudo retrospectivo	Dickinson et al.⁽⁴²42 Dickinson S, Tschannen D, Shever LL. Can the use of an early mobility program reduce the incidence of pressure ulcers in a surgical critical care unit? Crit Care Nurs Q. 2013;36(1):127-40.⁾	Estados Unidos	1.112	Cirúrgica	Mobilização passiva e ativa, posicionamentos, sentar à beira leito, ortostatismo, transferência para cadeira e deambular com ou sem assistência	Não relatado
Estudo retrospectivo	Ronnebaum et al.⁽⁴⁴44 Ronnebaum JA, Weir JP, Hilsabeck TA. Earlier mobilization decreases the length of stay in the intensive care unit. J Acute Care Phys Ther. 2012;3(2):204-10.⁾	Estados Unidos	28	Geral	Mobilização passiva e ativa no leito, alongamentos, transferências, treino de marcha	Não ocorreram
Estudo retrospectivo	Abrams et al.⁽²¹21 Abrams D, Javidfar J, Farrand E, Mongero LB, Agerstrand CL, Ryan P, et al. Early mobilization of patients receiving extracorporeal membrane oxygenation: a retrospective cohort study. Crit Care. 2014;18(1):R38.⁾	Estados Unidos	35	Clínica	Mobilização passiva e ativo-assistida no leito, posicionamento, sedestação à beira leito, transferências, ortostatismo, marcha estacionária e deambulação	Não relatado
Estudo retrospectivo	Witcher et al.⁽⁵²52 Witcher R, Stoerger L, Dzierba AL, Silverstein A, Rosengart A, Brodie D, et al. Effect of early mobilization on sedation practices in the neurosciences intensive care unit: a preimplementation and postimplementation evaluation. J Crit Care. 2015;30(2):344-7.⁾	Estados Unidos	68	Neurológica	Mobilização passiva e ativa, sedestação à beira do leito, ortostatismo e deambulação	Não relatado
Estudo retrospectivo	Clark et al.⁽¹¹11 Clark DE, Lowman JD, Griffin RL, Matthews HM, Reiff DA. Effectiveness of an early mobilization protocol in a trauma and burns intensive care unit: a retrospective cohort study. Phys Ther. 2013;93(2):186-96.⁾	Estados Unidos	2.176	Trauma e queimados	Mobilização passiva, sedestação à beira do leito, exercícios ativos, transferências, deambulação	Não ocorreram
Estudo retrospectivo	Olkowski et al.⁽⁵¹51 Olkowski BF, Devine MA, Slotnick LE, Veznedaroglu E, Liebman KM, Arcaro ML, et al. Safety and feasibility of an early mobilization program for patients with aneurysmal subarachnoid hemorrhage. Phys Ther. 2013;93(2):208-15.⁾	Estados Unidos	25	Neurocirúrgica	Posicionamentos, programa educacional, treinamento funcional e exercícios terapêuticos	EA em 5,9% das sessões. PAM < 70mmHg (9 pacientes), PAM > 120mmHg (7 pacientes) e paciente FC > 130bpm (1 paciente)
Estudo retrospectivo	Lee et al.⁽²⁵25 Lee H, Ko YJ, Suh GY, Yang JH, Park CM, Jeon K, et al. Safety profile and feasibility of early physical therapy and mobility for critically ill patients in the medical intensive care unit: Beginning experiences in Korea. J Crit Care. 2015;30(4):673-7.⁾	Coreia	99	Clínica	Estimulação elétrica neuromuscular, mobilização passiva e ativa, mobilização no leito, transferências, ortostatismo, exercícios terapêuticos e deambulação	26 potenciais EA (5,0%; IC95%, 3,4% - 7,3%) observados em 17 pacientes (17,2%; IC95%, 10,6% - 26,4%). O uso de ECMO foi um fator independente associado com EA com OR de 5,8 (IC95%, 2,2 - 15,6; p < ,001)
Estudo retrospectivo	Engel et al.⁽⁴⁰40 Engel HJ, Tatebe S, Alonzo PB, Mustille RL, Rivera MJ. Physical therapist-established intensive care unit early mobilization program: quality improvement project for critical care at the University of California San Francisco Medical Center. Phys Ther. 2013;93(7):975-85.⁾	Estados Unidos	294	Geral	Mobilização, ortostatismo, transferência para a cadeira, treino de marcha	Remoção acidental de dispositivos. Não foi quantificado
Série de casos	Winkelman et al.⁽⁵⁴54 Winkelman C, Higgins PA, Chen YJ. Activity in the chronically critically ill. Dimens Crit Care Nurs. 2005;24(6):281-90.⁾	Estados Unidos	19	Geral	Sem protocolo específico. Foi considerado como atividade terapêutica a mobilização passiva, sentar fora do leito e deambulação	Não relatado
Série de casos	Segers et al.⁽³⁹39 Segers J, Hermans G, Bruyninckx F, Meyfroidt G, Langer D, Gosselink R. Feasibility of neuromuscular electrical stimulation in critically ill patients. J Crit Care. 2014;29(6):1082-8.⁾	Bélgica	50	Geral	Estimulação elétrica neuromuscular	Não ocorreram
Série de casos	Pohlman et al.⁽²2 Pohlman MC, Schweickert WD, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Feasibility of physical and occupational therapy beginning from initiation of mechanical ventilation. Crit Care Med. 2010;38(11):2089-94.⁾	Estados Unidos	49	Geral	Mobilização passiva, ativo-assitida e ativa, sedestação à beira do leito, treino de equilíbrio, ortostatismo, marcha estacionária e deambulação	EA em 16% das sessões (80 de 498). Dessaturação (6%), aumento maior que 20% na FC (4,2%), assincronia/taquipneia (4%), agitação/desconforto (2%), perda de dispositivos (0,8%)
Série de casos	Drolet et al.⁽⁵⁰50 Drolet A, DeJuilio P, Harkless S, Henricks S, Kamin E, Leddy EA, et al. Move to improve: the feasibility of using an early mobility protocol to increase ambulation in the intensive and intermediate care settings. Phys Ther. 2013;93(2):197-207.⁾	Estados Unidos	426	Geral	Programa educacional, deambular com ou sem assistência	Não relatado
Série de casos	Davis et al.⁽²⁴24 Davis J, Crawford K, Wierman H, Osgood W, Cavanaugh J, Smith KA, et al. Mobilization of ventilated older adults. J Geriatr Phys Ther. 2013;36(4):162-8.⁾	Estados Unidos	230	Geral	Programa educacional, posicionamento no leito, treino de mobilização no leito, transferências e exercícios terapêuticos	Um EA em 171 sessões: hipotensão postural
Série de casos	Thomsen et al.⁽⁴⁵45 Thomsen GE, Snow GL, Rodriguez L, Hopkins RO. Patients with respiratory failure increase ambulation after transfer to an intensive care unit where early activity is a priority. Crit Care Med. 2008;36(4):1119-24.⁾	Estados Unidos	104	Respiratória	Sedestação à beira do leito, transferência para a cadeira, atividades funcionais e deambular com andador e/ou com ou sem auxílio extra	Não relatado
Série de casos	Hopkins et al.⁽⁵⁵55 Hopkins RO, Miller RR 3rd, Rodriguez L, Spuhler V, Thomsen GE. Physical therapy on the wards after early physical activity and mobility in the intensive care unit. Phys Ther. 2012;92(12):1518-23.⁾	Estados Unidos	72	Respiratória	Mobilização passiva e ativa, sedestação à beira do leito, transferências e deambulação	Não relatado
Série de casos	Harris et al.⁽³⁴34 Harris CL, Shahid S. Physical therapy-driven quality improvement to promote early mobility in the intensive care unit. Proc (Bayl Univ Med Cent). 2014;27(3):203-7.⁾	Estados Unidos	21	Cardiológica	Mobilização passiva e ativa, sedestação à beira do leito, transferências e deambulação	Não relatado
Série de casos	Perme et al.⁽³⁵35 Perme C, Nalty T, Winkelman C, Kenji Nawa R, Masud F. Safety and efficacy of mobility interventions in patients with femoral catheters in the ICU: a prospective observational study. Cardiopulm Phys Ther J. 2013;24(2):12-7.⁾	Estados Unidos	77	Cardiovascular	Sedestação à beira do leito, transferência para a cadeira e deambulação	Não ocorreram
Série de casos	Titsworth et al.⁽⁴³43 Titsworth WL, Hester J, Correia T, Reed R, Guin P, Archibald L, et al. The effect of increased mobility on morbidity in the neurointensive care unit. J Neurosurg. 2012;116(6):1379-88.⁾	Estados Unidos	170	Clínica	Posicionamento, mobilização passiva e ativa, sedestação à beira do leito, transferências, ortostatismo e deambulação	Não ocorreram
Série de casos	Bourdin et al.⁽³⁸38 Bourdin G, Barbier J, Burle JF, Durante G, Passant S, Vincent B, et al. The feasibility of early physical activity in intensive care unit patients: a prospective observational one-center study. Respir Care. 2010;55(4):400-7.⁾	França	20	Clínica	Mobilização no leito e fora dele, transferências com e sem apoio, deambulação	EA em 3% das sessões (13 de 424): dessaturação (< 88%) por mais de 1 minuto (4 pacientes), extubação não programada (1 paciente), hipotensão postural (1 paciente) e queda do tônus muscular (7 pacientes)
Série de casos	Bailey et al.⁽¹⁰10 Bailey P, Thomsen GE, Spuhler VJ, Blair R, Jewkes J, Bezdjian L, et al. Early activity is feasible and safe in respiratory failure patients. Crit Care Med. 2007;35(1):139-45.⁾	Estados Unidos	103	Respiratória	Sedestação à beira e fora do leito, deambulação	EA em menos de 1% das atividades (14 de 1449) mais frequentes: queda sem lesões, hipotensão, dessaturação, remoção de sonda de alimentação e um episódio de hipertensão
Série de casos	Berney et al.⁽⁴⁹49 Berney S, Haines K, Skinner EH, Denehy L. Safety and feasibility of an exercise prescription approach to rehabilitation across the continuum of care for survivors of critical illness. Phys Ther. 2012;92(12):1524-35.⁾	Austrália	74	Geral	Mobilização no leito, marcha estacionária, treino de sentar e levantar, e deambulação	Não ocorreram

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[1] Autor correspondente: Thais Martins Albanaz da Conceição. Hospital Universitário Polydoro Ernani de São Thiago. Universidade Federal de Santa Catarina - Campus Universitário. Rua Professora Maria Flora Pausewang, s/nº - Trindade. Caixa Postal: 5.199. CEP: 88036-800 - Florianópolis (SC), Brasil. E-mail: thaisfisio13@gmail.coms