Early Physical and Occupational Therapy in Mechanically Ventilated, Critically Ill Patients: A Randomised Controlled Trial
Lancet, 2009 · Multicenter, parallel-group randomized controlled trial
Clinical question
Does early physical and occupational therapy during daily sedation interruption improve functional independence and delirium in ventilated ICU patients?
What the trial found
Early mobilization during sedation interruption significantly improves functional recovery at hospital discharge and decreases ICU delirium and ventilator duration.
Current guideline position
Strong recommendation in SCCM PADIS guidelines to implement early mobilization protocols to reduce ICU-acquired weakness and delirium.
Clinical interpretation
Core foundational trial supporting early mobilization protocols to prevent and mitigate ICU-acquired weakness (CIP/CIM).
Critical illness polyneuropathy and myopathy: recognition, risk reduction, diagnostic approach, ventilator liberation, rehabilitation, and prognosis.
Analgesia-first sedation, light sedation targets, ABCDEF bundle, spontaneous breathing trials, and non-pharmacologic delirium mitigation.
Complete clinical topic overview. For the full 10-level interactive course, visit Master MV. Covers core ventilator modes, respiratory mechanics (Cstat, Raw, driving pressure), waveform dyssynchrony analysis, VILI prevention, and liberation protocols.