- Design
- Multicentre, open-label randomised trial
- Population
- 169 ventilated adults with sepsis or respiratory failure, South Korea
- Primary outcome
- Functional Status Score for the ICU at ICU discharge
- Effect
- 23.6 vs 22.2, P = 0.44; no difference in 12-month outcomes
EVER randomised 169 adults with sepsis or respiratory failure expected to need at least 48 hours of ventilation, at five South Korean hospitals. Patients received a structured six-step mobilisation programme or usual care. The primary outcome was the Functional Status Score for the ICU at discharge, with follow-up to 12 months.
The programme delivered more mobilisation, starting earlier (30 vs 46 hours), with more sessions (11 vs 4) and more time (330 vs 120 minutes). Function at ICU discharge did not differ (23.6 vs 22.2), and quality of life, cognition and post-intensive care syndrome measures improved similarly in both groups over a year. Patients who reached sit-to-stand or beyond did better, but that comparison is observational.
This adds to trials showing that more mobilisation, delivered earlier, does not by itself improve outcomes. Mobilisation remains good care, but protocols that push the amount of activity should not be expected to change function. Reaching a patient's achievable level safely may matter more.
- Continue mobilisation as part of routine ICU care
- Do not expect a more intensive protocol alone to improve function at discharge
- Aim for the highest step each patient can safely reach
- Screen survivors for post-intensive care syndrome at follow-up
Why it matters
It challenges the assumption that more, earlier mobilisation is better for every ventilated patient.
Don't overread it
The trial was small, open-label and unequal in group size, so it cannot exclude a modest benefit.
The statistics, in plain English
The FSS-ICU difference of 1.4 points (P = 0.44) is small and not significant. The better scores in patients reaching sit-to-stand come from a matched comparison, so less sick patients naturally reach higher steps; this does not show the protocol caused the benefit.
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