Currently submitted to: JMIR Research Protocols
Date Submitted: Dec 12, 2025
Open Peer Review Period: Dec 16, 2025 - Feb 10, 2026
(closed for review but you can still tweet)
NOTE: This is an unreviewed Preprint
Warning: This is a unreviewed preprint (What is a preprint?). Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn (a note "no longer under consideration" will appear above).
Peer review me: Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period (in this case, a "Peer Review Me" button to sign up as reviewer is displayed above). All preprints currently open for review are listed here. Outside of the formal open peer-review period we encourage you to tweet about the preprint.
Citation: Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author).
Final version: If our system detects a final peer-reviewed "version of record" (VoR) published in any journal, a link to that VoR will appear below. Readers are then encourage to cite the VoR instead of this preprint.
Settings: If you are the author, you can login and change the preprint display settings, but the preprint URL/DOI is supposed to be stable and citable, so it should not be removed once posted.
Submit: To post your own preprint, simply submit to any JMIR journal, and choose the appropriate settings to expose your submitted version as preprint.
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Efficacy of early mobilization in mechanically ventilated critically ill patients: protocol for a systematic review and trial sequential meta-analysis
ABSTRACT
Background:
Mechanically ventilated critically ill patients face significant risks from prolonged immobilization, including ICU-acquired weakness and prolonged recovery. Early mobilization is increasingly advocated to mitigate these risks. While existing studies suggest early mobilization may reduce ventilator days and ICU length of stay, its impact on mortality remains unclear due to conflicting results and methodological limitations, particularly insufficient statistical power and the lack of conclusive evidence. This uncertainty necessitates a more robust synthesis incorporating Trial Sequential Analysis (TSA) to evaluate the reliability and conclusiveness of current evidence regarding early mobilization's efficacy.
Objective:
evaluate the reliability and conclusiveness of current evidence regarding early mobilization's efficacy.
Methods:
Randomized controlled trials (RCTs) that compare early mobilization and usual care in mechanically ventilated critically ill patients will be included. Literature searches will be conducted in PubMed, Web of Science, Embase, and Cochrane Library. Two reviewers will independently perform the processes of literature retrieval, screening, data extraction, and assessment of risk of bias. Risk of bias in included studies will be evaluated using Revised Cochrane risk-of-bias tool (ROB 2) for RCTs. Review Manager (RevMan) will be used for data pooling. Subgroup analysis, trial sequential analysis (TSA), and sensitivity analysis will be conducted.
Results:
Not applicable
Conclusions:
Not applicable
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.