Résumé
Current evidence supports early mobilization (EM); rehabilitation of ICU patients,under mechanical ventilation or not, improves functional outcomes and is found to be safe.However, little is known about EM of neurocritical patients, especially because EM is still seen asa potentially dangerous intervention in neurological ICU patients.Objective: to review safety data regarding patient rehabilitation in the Neuro-ICU, and tocompute incidence of adverse events such as hemodynamic changes, clinical deterioration,removal or dysfunction of respiratory tubes, intravascular catheters, other external disposals andfalls.Material and Method: data Sources: systematic literature review, including searches of 4 databases. Eligible studies forthe statistical analysis evaluated adult patients who received an EM program in a Neuro-ICU atan early stage <7 days, and provided data to allow the computation of incidence of adverseevents.Data Extraction: number of patients, mobilization/rehabilitation sessions, type of interventionand session time, and potential safety events and adverse events with negative consequences(requiring intervention or additional therapy).Results: synthesis: heterogeneity was assessed by I-square statistics, and bias assessed by the Newcastle-Ottawa Scale and Cochrane risk of bias assessment. The literature search identified 1134 titles.There were 4 eligible publications for the statistical analysis part, evaluating 195 patients, with95 potential safety events (12%) and 3 safety events with consequence (0.4%), occurring in 793mobilization/rehabilitation sessions, with an average of 27.8 minutes/session. There washeterogeneity in the definition of these events. Most potential safety events were modificationsof vital signs without any clinical or therapeutic consequence.15 studies were used for systematic review.Conclusion: early rehabilitation in NICU appears to be safe with a low incidence of safety events, not havingany consequences for patient management.