A Study on Early Mobility in the ICU is Making Some Pretty Controversial Claims. How Did it Come to These Conclusions?

As far as the early mobility community is concerned, the benefits of early mobility in the intensive care unit are not up for debate. There are mountains of evidence to show these benefits and support the safety and efficacy of early mobility in the ICU, and this is something I’ve documented repeatedly. But unfortunately, ICUs

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How the ABCDEF Bundle Can Improve the Quality of Death for ICU Patients

How the ABCDEF Bundle Can Improve the Quality of Death for ICU Patients

Over the years, I’ve witnessed first-hand how the ABCDEF Bundle’s evidence-based practices can reduce healthcare costs, while improving patient outcomes and working conditions in the ICU. But even though evidence shows that the ABCDEF Bundle can decrease the risk of death by 68 percent, its success is not always found in a patient’s ability to

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ICU testimonialI stumbled upon Kali’s podcast midway through my anesthesia critical care fellowship in February 2021. At our institution, I got the impression that patients in the ICU either got better on their own or had a prolonged and complicated course to LTAC or death. In her podcast, Kali explained that LTAC was rarely the outcome for patients in the Awake and Walking ICU in Salt Lake City.

Their ICU survivors hardly ever got trached, PEGed, or sent to LTAC, and literally walked out of the hospital in condition as close to their previous health as they could be. Although the concept of using no sedation on ventilated patients was completely foreign to me, it made sense based on what I had read in the literature. I devoured all of the episodes from the beginning, many of them bringing tears and regret for my ignorance, followed by inspiration and hope in later episodes. Listening to her podcast has been one of the most profound experiences in my short, eight-year career in medicine.

After discovering the no sedation, early mobility practice at the Awake and Walking ICU, my focus shifted to bringing it to my own institution. I visited Salt Lake City in March to witness it with my own eyes. Since then, I’ve been in touch closely with Kali and Louise to learn the practical approaches to sedation wean and sedation avoidance for newly intubated patients in the ICU.

Mikita Fuchita, MD
Colorado, USA

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Perception Versus Reality: Debunking The Myths About Medically-Induced Comas

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