Discussion Guide for the Krupp Article

Early mobilization of critically ill patients is associated with reductions in complications of prolonged bed rest such as muscle atrophy, cardiovascular deconditioning, respiratory impairments, and intensive care unit (ICU) delirium. Encouraging physical activity in these patients promotes physical and psychological recovery, reduces ICU length of stay, and improves overall patient outcomes. Implementation of early mobility interventions can reduce the duration of delirium, mechanical ventilation, and ICU/hospital stay. Thus, clinical practice guidelines recommend early mobilization in critically ill adults, and early mobility interventions are an essential element in the Society of Critical Care Medicine’s (SCCM) ICU Liberation Bundle (ie, the ABCDEF bundle). Although the ABCDEF bundle is consistently associated with improvements in patient-centered clinical outcomes, its adoption on a wide scale remains low and highly variable. The underuse of early mobility interventions contributes to incomplete bundle execution. For instance, fewer than one-third of patients in SCCM’s ICU Liberation Collaborative received early...