Does Early In-Bed Cycle Ergometry Benefit Critically Ill Patients?

Many patients leave the intensive care unit (ICU) with substantial physical limitations related to immobility and critical illness. Despite early studies that suggested benefits related to early mobilization and physical therapy, more-recent trials have had mixed results (e.g., NEJM JW Gen Med Dec 15 2022 and N Engl J Med 2022; 387:1747).

Investigators from Canada randomized 360 mechanically ventilated patients (mean age, 61) within 4 days of intubation to early in-bed cycle ergometry plus usual physical therapy or to usual physical therapy alone. At enrollment, more than half of patients were supported with vasopressors. Both groups received similar amounts of usual physical therapy. Cycling was done in a semi-recumbent position on a specia…