Intensive Care Unit Acquired Weakness Critical Illness Mechanical Ventilation Muscle Weakness Intensive Care Unit Acquired Weakness Early NAWM Care Bundle Mechanically Ventilated Critically Ill Patients Muscle Strength Mobility Mechanical Ventilation Critical Care Early Mobilization
Conditions
Interventions
Participants received the Early NAWM Care Bundle in addition to standard nursing care for 7 days. The intervention consisted of four evidence based components: (1) Early Nutrition and Glycemic Control
(2) Early Awakening, including daily assessment for spontaneous awakening trials and sedation reduction or interruption when clinically appropriate to achieve awakening within 72 hours
(3) Early Weaning from Mechanical Ventilation, including daily assessment for spontaneous breathing trials and ventilator weaning within 7 days when clinically appropriate
and (4) Early Mobilization, including daily mobility assessment and progressive mobilization within 72 hours according to patient readiness and physician approval. The intervention was delivered accor
Early NAWM Care Bundle,Standard Nursing Care
Sponsors
Faculty of Medicine Ramathibodi Hospital, Mahidol University
Faculty of Medicine Ramathibodi Hospital, Mahidol University
Eligibility
Sex/Gender
All
Age
18 Years to 70 Years
Inclusion criteria
Inclusion criteria: 1. Adult critically ill patients aged 18 to 70 years. 2. Mechanically ventilated within 48 hours of hospital admission. 3. Glasgow Coma Scale score greater than 10. 4. Barthel Index score greater than 12 within one week before hospitalization. 5. APACHE II score less than 25 on ICU admission. 6. Moderate to high risk for ICU Acquired Weakness. 7. Able to participate in the Early NAWM Care Bundle as determined by the attending physician. 8. Written informed consent obtained from the patient or legal representative. 9. Not pregnant. 10. No history of neuromuscular disease, major neurological injury, limb disability, recent major orthopedic surgery, or recent abdominal surgery. 11. Met safety criteria for early mobilization within 72 hours after ICU admission.
Exclusion criteria
Exclusion criteria: 1. Advanced metastatic cancer or severe cancer related pain. 2. Active bleeding, including active gastrointestinal bleeding. 3. Increased intracranial pressure. 4. End stage disease with an expected survival of less than 6 months.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Muscle Strength Day 7 Medical Research Council Sum Score (MRC SS),Mobility Status Day 7 Intensive Care Unit Mobility Scale (IMS) | — |
Secondary
| Measure | Time frame |
|---|---|
| Duration of Mechanical Ventilation At hospital discharge Number of days receiving mechanical ventilation,ICU Length of Stay At ICU discharge Number of days in intensive care unit,Hospital Length of Stay At hospital discharge Number of days hospitalized | — |
Countries
Thailand
Contacts
Public ContactSawanee Bumrungwong
Faculty of Medicine Ramathibodi Hospital
Outcome results
None listed