Early rehabilitation in the intensive care unit is a promising component of post-intensive care syndrome (PICS) treatment and prevention. However, the optimal time to start mobilizing critically ill patients is still to be determined.

OBJECTIVE

To evaluate the effect of rehabilitation initiation timing on outcomes in patients with pneumonia.

MATERIAL AND METHODS

The study included 106 patients with pneumonia (27 patients with community-acquired pneumonia and 79 patients with early-onset healthcare associated pneumonia) who received daily rehabilitation treatment for at least 7 days in the intensive care unit. All patients were retrospectively assigned to the early rehabilitation (ER) group if rehabilitation treatment was started within the first 48 hours of admission to the intensive care unit or the delayed rehabilitation (DR) group if mobilization was not initiated within this time frame.

RESULTS

The baseline clinical and demographic characteristics of the patients did not differ between the groups. During rehabilitation, rates of catecholamine use and the psychiatric signs of PICS frequency were also comparable. The duration of mechanical ventilation was 1.5 times shorter in ER group patients than in DR group (8 vs. 6 days and 13 vs. 9 days, respectively; p=0.003). The ICU and hospital stay were also significantly shorter in ER group compared with the DR group (12 (9—16) vs. 19 (13—30), respectively; p<0.001; 23 (12) vs. 31 (13) as inpatients, respectively; p=0.005). Mortality and severe complications rate were comparable between the groups.

CONCLUSIONS

The earliest possible start of rehabilitation provided the patient’s condition is stable, can reduce the duration of respiratory support and hospital stay for patients with pneumonia.