Bakgrund: Under året 2020 spreds Covid 19-viruset och en global pandemi bröt ut. Patienterna som vårdades på intensivvårdsavdelningar hade symtom i form av respiratorisk insufficiens och vårdades i respirator. Intensivvårdssjuksköterskorna ställdes inför en ny patientkategori med avvikande symtom och reaktioner på behandling. Att träna ur patienter från respirator är en tidskrävande process som kräver förberedelser och planering. Hänsyn ska tas till flera faktorer, både fysiska, psykiska och miljömässiga. Syfte: Syftet var att beskriva intensivvårdssjuksköterskors upplevelser av urträningsprocessen vid respiratorbehandling av patienter med Covid-19.Metod: En intervjustudie med kvalitativ ansats gjordes och författarna analyserade materialet genom kvalitativ innehållsanalys. Totalt medverkade 10 intensivvårdssjuksköterskor i studien. Huvudresultat: Huvudkategorierna som framkom ur resultatet var ”intensivvårdssjuksköterskans nya erfarenheter och utmaningar under urträningsprocessen” ” Det kollegiala stödet är viktigt” samt ”behov av tydligare struktur för personalen under urträningsprocessen”. Det essentiella som identifierades var intensivvårds-sjuksköterskornas upplevelse av att arbeta med en ny och dittills okänd patientkategori, de upplevde det som en utmaning både yrkesmässigt och känslomässigt. De emotionella känslorna som intensivvårds-sjuksköterskan upplevde att hon ställdes inför var uppgivenhet, meningsfullhet, tålamodsprövning och svårigheten av att se patienterna lida av ångest. Det kollegiala stödet var betydelsefullt under den här perioden men bristen på fysioterapeuter, riktlinjer och kontinuitet identifierades.Slutsats: Att inte kunna förlita sig på sin tidigare kunskap gällande patientens vård upplevdes som frustrerande och osäkert eftersom Covid-19 är och var en ny sjukdom. Genom att utarbeta riktlinjer, upprätthålla en god kollegial stämning, skapa högre tillgänglighet av fysioterapeuter samt att vårdarbetet genomsyras av kontinuitet så kan patientsäkerheten öka, arbetsmiljön optimeras och intensivvårdssjuksköterskan kan känna en högre grad av säkerhet i sitt arbete. Det identifierades både organisatoriska och patientrelaterade faktorer som eventuellt kan ha påverkat längden på urträningsprocessen från respirator. / Background: During 2020, COVID-19 spread across the globe resulting in a pandemic. Patients that required intensive care suffered from respiratory insufficiency and were put on mechanical ventilation support. Intensive care unit (ICU) nurses were exposed to a new category of patients with unfamiliar symptoms and unpredictable reactions to treatment. Weaning patients from mechanical ventilation is a time consuming process that requires preparation and planning. Consideration needs to be taken to both physiological and psychological factors. Aim: To describe the ICU nurses´experiences on weaning patients with Covid-19 from mechanical ventilation. Method: An interview study with qualitative approach was used and the authors analyzed the material through context analysis. A total of 10 ICU nurses participated in the study. Results: The Category that appeared from the result was ”ICU nurses new experience and challengesin the weaningprocess” “The collaboration with the teams is important” and “ The need for better structure under the weaningprocess”. The essential that was identified was the ICU nurses´experience from working with a new and until then unknowncategory of patients, they experienced it as a challenge, both professional and emotional. Emotions that the ICU nurses´felt was a feeling of resignation, meaningfullness, patience testing and the struggle of seeing patients with anxiety. The support from colleagues was signficant under this period but the lack of physiotherapists, guidelines and need of continuity in the care for the patients was identified. Conclusion: To not be able to rely on ones previous knowledge about patients caregiving was frustrating and uncerting because the Covid 19 was a new type of disease. By developing guidelines, maintaining good teamwork, create a higher availability of physiotherapists and to let the caregiving of patients contain continuitycan the patient safety be increased, the working evironment can be optimized and the ICU nurse can feel a higher experience of surety in her work. It was identified that the organizational and patient related factors could have prolonged the weaning process from mechanical ventilation.

Improvements in technology have allowed people with tracheostomies to live at home on mechanical ventilation (HMV). Quality of life (QOL) for HMV users has been studied quantitatively, but few qualitative studies have been published. The purpose of this phenomenological study was to explore QOL for individuals with tracheostomies on prolonged HMV focusing on activities of daily living (ADLs) and the role of decision- making. The Roper, Logan, and Tierney activities of living theory were used to categorize activities. Ten participants, 18 years and older, with a tracheostomy and on HMV for at least 6 months were enrolled using purposive sampling. Data were collected through structured, in-depth, face-to-face interviews. Themes that emerged were (a) autonomy, (b) significance of ventilator for well-being, (c) feeling tied up, (d) creating meaning, (e) tipping point, (f) reminiscence, (g) building trust and confidence, (h) adjusting to technology, (i) family support and relationships, and (g) meaning of life. The participants were relatively healthy and their QOL was improved when they were on HMV compared to the hospital. The participants felt empowered that they had control in their daily lives at home when they had competent caregivers and family members for continuity of care. Recommendations for future research would include exploring improved methods of collaboration among health care workers and families in providing holistic care and reducing role strain and isolation in young HMV users. The study may promote positive social change through education for family, health care workers, and the public about strategies to promote independence and subsequent improvement in QOL for individuals on HMV.

There are few recommendations on how best to apply certain modes of mechanical ventilation. The application of Airway Pressure Release Ventilation (APRV) includes strategic implementation of specific inspiratory times (I-times) and particular mean airway pressures (MAWP) neither of which is standardized. This study utilized a retrospective analysis of archived electronic health record data to evaluate the clinical outcomes of adult patients that had been placed on APRV for at least 8 hours. 68 adult subjects were evaluated as part of a convenient purposive sample. All outcomes of interest (surrogates) for short-term clinical outcomes to include the PaO2/FiO2 (P/F) ratio, Oxygen Index and Oxygen Saturation Index (OI; OSI), and Modified Sequential Organ Failure Assessment (MSOFA) scores showed improvement after at least 8 hours on APRV. Most notably, there was significant improvement in P/F ratio (p = .012) and OSI (p = .000). Results of regression analysis showed P low as a statistically significant negative predictor of pre-APRV P/F ratio with a higher initial P low coinciding with a lower P/F ratio. The regression analysis also showed MAWP as a significant positive predictor of post-APRV OSI and P high and P low as significant negative predictors of post-APRV MSOFA scores. In summary, it was found that settings for P high, Plow, and T low in addition to overall MAWP and Body Mass Index (BMI) had significant correlation to impact at least one of the short-term clinical outcomes measured.

The aim of this master thesis is to design an office building for research institute in Brno. In the first part there is designed building structure. The building has two floors. First floor with four offices, toilets, storerooms, kitchen and utility room and second floor with two offices, toilets, conference room, kitchen and two roof terraces. The main entrance is oriented towards north. Load-bearing and non-load-bearing walls are designed from aerated concrete blocks, floor slabs are from cast-in-place reinforced concrete. The building façade is insulated with ETICS. In the second part there are designed systems of heating, mechanical ventilation, cooling, lighting and use of rainwater. Third, cooling analysis of research institute AdMaS in Brno is made. The designs are drawn in AutoCAD, thermal calculations in DEKsoft.

Bei Patienten mit einem akuten Lungenversagen (ALI oder ARDS) ist der Sauerstoffverbrauch der Lunge (VO2pulm) durch pathophysiologische Prozesse insbesondere die Ausbildung von Atelektasen stark beeinträchtigt. Aufgrund der Annahme, dass eine Steigerung der Anzahl ventilierter Lungenareale zu einer Erhöhung des pulmonalen Sauerstoffverbrauchs führt, haben wir den Einfluss eines definierten Rekrutierungsmanövers (PEEP/PEAK + 10 cmH2O) auf den pulmonalen Sauerstoffverbrauch (VO2pulm), pulmonalen kapillären Blutfluss (PCBF), der den nicht geshunteten Anteil am HZV darstellt, und den transpulmonalen Shunt (Qs/Qt) untersucht. In der vorliegenden Studie wurde der VO2pulm als Differenz zwischen dem Sauerstoffverbrauch des gesamten Körpers, gemessen über die indirekte Kalorimetrie (VO2cal), und dem über das inverse Fick`sche Prinzip errechneten Sauerstoffverbrauch (VO2Fick) bestimmt. Im Rahmen einer klinisch-prospektiven Studie konnten nach Annahme des Studienprotokolls durch die zuständige Ethikkommission 13 beatmete Patienten, welche die Consensus-Kriterien eines ALI oder ARDS erfüllten, eingeschlossen werden. Nach Sicherstellung einer adäquaten Volumensituation und Messung der Ausgangsparameter wurde der PEEP um 10 cmH2O erhöht. Um ein stabiles Atemzugvolumen (VT 6-8 ml/kgKG) und damit gleichbleibende Bedingungen für die alveoläre Ventilation bis auf das von uns durchgeführte Rekrutierungsmanöver zu gewährleisten, wurde zeitgleich der Spitzendruck ebenfalls um 10 cmH2O erhöht. Nach 15 und 60 min wurden die Zieldeterminanten pulmonaler Sauerstoffverbrauch (VO2pulm), PCBF und transpulmonaler Shunt erneut bestimmt. Die Messung der indirekten Kalorimetrie (VO2cal) wurde mit dem Deltatrac TM, MBM 200® durchgeführt, VO2Fick über die Thermodilutionsmethode ermittelt, die partielle CO2-Rückatmungsmethode (David®) zur Bestimmung des PCBF genutzt und der transpulmonale Shunt (Qs/Qt) mittels der Formel nach BERGGREN berechnet. Die statistische Auswertung der Daten erfolgte mittels T-Tests für gepaarte Stichproben. Nach dem Manöver konnte eine signifikante Steigerung des PCBF von 4,44 ± 1,15 l/min auf 5,4 ± 1,68 l/min nach 15 min, respektive 5,12 ± 1,67 l/min nach 60 min nachgewiesen werden (p<0,025). Dieser Anstieg wurde von einer signifikanten Reduktion des transpulmonalen Shunts (Qs/Qt) von 0,24 ± 0,08 auf 0,16 ± 0,07 nach 15 min und 0,16 ± 0,07 nach 60 min begleitet (p<0,005). Diese Veränderungen der pulmonalen Hämodynamik gehen mit statistisch relevanten Verbesserungen der Oxygenierung sowie der Atemmechanik einher. Eine signifikante Steigerung des pulmonalen Sauerstoffverbrauchs konnte für die gesamte Studienpopulation nicht festgestellt werden. In dieser Untersuchung steigt der Sauerstoffverbrauch der Lunge deskriptiv von baseline 10,1 +/- 30,59 ml/min über 11,42 +/- 27,42 ml/min nach 15 min, respektive auf 28,69 +/- 56,75 ml/min nach 60 min an. Die signifikante Steigerung des pulmonal-kapillären Blutflusses und die konsekutive Reduktion des transpulmonalen Shunts schon 15 min nach dem Manöver impliziert einen Anstieg der an der alveolären Ventilation teilnehmenden alveolokapillären Einheiten, was einer Rekrutierung von vorher atelektatischen Lungenabschnitten entspricht. Insbesondere bei ARDS-Patienten und Respondern konnten Rekrutierungs-induzierte Veränderungen detektiert werden, wohingegen die Patienten mit ALI oder Nonresponder keinerlei statistische Unterschiede während der Intervention zeigten. Trotz stattgefundener Wiederbelüftung von Atelektasen konnte ein statistisch relevanter Unterschied bezüglich des pulmonalen Sauerstoffverbrauchs durch das Rekrutierungsmanöver für die gesamte Studienpopulation nicht festgestellt werden.

Nowadays individuals spend more than 85% of their total time in indoor environments, mainly at home and work. Thereby, the quality of the indoor environment plays a substantial role in human health and wellness. The four basic factors that define the perception of the indoor environment, through the senses, are the thermal comfort, the indoor air quality, the acoustical quality and the visual or lighting quality. A standard level of the above factors is ensured by the building envelope and the services systems. At the same time, the bearing structure provides the necessary resistance and durability to the construction in order to sustain the various loads without breaking down. Inevitably, over the years, all structures’ robustness declines and their functionality state degrades. For that reason, intensive provision should be given to assure the users’ safety and well-being. The objective of this study is to assess the current indoor air quality, the thermal comfort and the damages at four publicly owned buildings located in Athens, Greece. The evaluation was done through the facilities management contribution, a questionnaire survey and a technical visit – inspection where measurements were taken. Special focus was also put on the Sick Building Syndrome (SBS) and its effects. The results indicated that at 3 out of 4 buildings mainly suffer from unpleasant odors and lack of fresh air intake. Therefore, the installation of mechanical ventilation systems (air handling units, outdoor air processing units) combined with an effective air distribution system (confluent jet ventilation system) is suggested. Substantial building damages were detected at the cultural center (floorings, door/window openings, fungi) and specific proposals for restoration are made. Despite the existence of indicators of an unhealthy indoor environment, a direct correlation between the exposure to various pollutants and the SBS symptoms, cannot be established. The optimization of the research methodologies and the institution of new building design protocols is essential in order to overcome the SBS effects. On the whole, the questionnaire achieved to fulfil the objectives of the survey. It was comprehensible by the respondents while the outcome of the questionnaire and the inspection were consistent to each other. The questionnaire and the checklists are practical tools that could be used as a guide for future investigation in similar fields. Except for technical surveys and questionnaires, many suggestions for future maintenance of the buildings are provided aiming to retain their functionality. These proposals concern the services systems, the building envelope as well as the bearing structure of the buildings.

As energy prices keep increasing, energy efficiency measures have come to the spotlight, especially in the residential sector. In this context, energy audits appear as powerful tools in order to assess the energy use and cost of energy of a dwelling, and identify possible energy saving measures that increase the energy efficiency and reduce costs. This work performs an energy audit of a single-family house (SFH) built in the 1970s which uses district heating, located in Gävle, Sweden. An empirical and quantitavive approach is followed, where energy data from the bills of 2022 together with on-site ventilation measurements is combined as a way to determine the energy inflows and outflows of the dwelling. Results concluded that the ventilation needs to be improved as a way to meet the Swedish building regulations. In addition, the energetic situation could be improved by means of the installation of solar photovoltaic (PV) modules to cover part of the electricity demand and solar thermal collectors to cover part of the domestic hot water demand. These measures would decrease the costs of the energy bills 4689 SEK/year at the time they would provide a source of renewable energy. The replacement of windows was also studied, concluding the payoff time to be excessively long to be accepted.

L’ajustement de la pression expiratoire positive (PEP) durant la ventilation est difficile faute de cibles objectives. Cet enjeu est important en pédiatrie, car les nourrissons sont à risque de dérecrutement alvéolaire du fait de la faible rigidité de leur cage thoracique. Pour prévenir cela, ils maintiennent activement leurs volumes pulmonaires en conservant une activité tonique diaphragmatique (Edi tonique) durant l’expiration. La détection d’une Edi tonique élevée est donc un outil potentiel pour titrer la PEP. L’étude présentée dans ce mémoire a permis de proposer une première définition de l’Edi tonique élevée aux soins intensifs pédiatriques, soit > 3,2 mcV chez les 0-1 an et > 1,9 mcV chez les 1-18ans. Cette définition permettra d’aider à identifier au chevet les patients effectuant des efforts de recrutement et ainsi de pouvoir réévaluer le niveau optimal de PEP. Nous avons également montré que des épisodes d’Edi tonique élevée surviennent chez 62% des patients en ventilation non-invasive et 31% des patients intubés. Ces épisodes sont associés avec la bronchiolite, la tachypnée, et, chez les patients en ventilation non-invasive, à une hypoxémie plus sévère. La majorité des patients ayant présenté des épisodes n’avaient pas de contreindications à l’augmentation de la PEP. Ceci porte à croire qu’une stratégie d’ajustement neural continu de la PEP pourrait être une avenue intéressante. Nous complétons donc présentement l’étude NeuroPAP2 visant à évaluer la faisabilité, la tolérance et l’impact du mode NeuroPAP, un mode de ventilation permettant un ajustement continu de la PEP en fonction de l’Edi. / The optimal adjustment of ventilatory settings at the bedside is a challenge and the lack of clear targets makes setting the PEEP (positive end expiratory pressure) especially difficult. This is an important issue in pediatrics, as infants are at increased risk for alveolar derecruitment because of high chest wall compliance. To prevent this, they tend to actively maintain end expiratory lung volumes using tonic diaphragmatic activity (tonic Edi) throughout expiration. In older children, tonic Edi can be reactivated in disease states. Tonic Edi monitoring is thus a potential tool to guide PEEP titration. This thesis addresses important knowledge gaps about tonic Edi in ventilated children. We propose age-specific definitions of elevated tonic Edi in PICU patients: > 3.2 mcV in 0-1 y.o. and > 1.9 mcV in 1-18 y.o. These definitions will aid bedside identification of patient lung recruitment efforts and can prompt reassessment of optimal PEEP. We have also established that episodes of high tonic Edi are frequent in ventilated children (31% of intubated patients and 62% of patients on non-invasive ventilation). Those episodes are associated with bronchiolitis, tachypnea, and, in NIV patients, more severe hypoxemia. The majority of patients with those episodes have no contraindications to increased PEEP. These results make continuous neural adjustment of PEEP an interesting avenue. We are thus now completing this research program with a study to evaluate the feasibility, tolerance and impact of NeuroPAP, a new ventilatory mode allowing continuous neural adjustment of PEEP based on tonic Edi.

Artificial breathing is vital when it comes to treatment of critically ill patients where the natural breathing mechanism is insufficient. With the help of mechanical ventilators, the natural breathing mechanism of the patient can be assisted or even exchanged with the artificial breathing from the machine. Small errors and unexpected events in these systems may lead to serious damages on the patients, causing even more harm than good. Therefore, these systems require a lot of testing and monitoring to ensure functionality. With the use of accurate simulation models, testing time can be reduced by running test in the simulation environment instead of on the actual machine. The simulation models can also be used for monitoring functions in real time, making sure the ventilation of the patient is working as expected. When it comes to simulating a ventilator system controlled with high frequency ventilation techniques, the existing simulation models fail to reproduce the high frequency dynamics that appear during high frequency ventilation. This paper proposes a modelling approach for mechanical ventilator systems exposed to high frequency dynamics. Focus is placed on modeling the patient circuit including the inspiratory and expiratory tubes, the humidifier with the dry line tube, the Y-piece, the tracheal tube and the patient lungs. The model is based on mathematical models representing the thermodynamic and pneumatic behaviour of the system. It is built using Simulink with regular and customized building blocks from Simscape. Compared to pre-existing simulation models, this model includes the inertia effects of the gas which is crucial when it comes to accurately modeling the system while being exposed to fast changes in flow and pressure. To evaluate the model performance, the simulated pressure and flow at the patient port are compared to measured data from an experimental setup. From the results of this thesis it was seen that the model is very sensitive to the patient model used in the simulation environment, which means that the patient model has to be remodeled in order to archive a better model performance. Compared to the pre-existing model used for comparison in this thesis, it is seen that an increased parameter model produces more accurate results. / Konstgjord andning är livsavgörande när det kommer till behandling av kritiskt sjuka patienter där den naturliga andningsmekanismen inte fungerar som den ska. Med hjälp av mekanisk ventilation kan den naturliga andningsmekanismen hos patienten assisteras eller helt ersättas av denna konstgjorda andning. Små fel eller oväntade händelser i dessa system kan vara livsfarliga för patienten och kan orsaka mer skada än nytta. Detta gör att dessa system kräver mycket testning och övervakning för att säkerställa att allt fungerar som tänkt. Med hjälp av noggranna simuleringsmodeller kan testtiden minskas samtidigt som dessa simuleringsmodeller kan användas för övervakning av systemet i realtid, detta för att säkerställa systemets funktion. När det kommer till simulering av ventilatorsystem som ventileras med högfrekventa ventilationstekniker, misslyckas de befintliga simuleringsmodellerna att återskapa den högfrekventa dynamik som uppstår under högfrekvent ventilation. Denna uppsatts föreslår en modelleringsmetod för att kunna modellera mekaniska ventilatorsystem som utsätts för högfrekvent dynamik. Fokus för projektet har varit att modellera patientkretsen inklusive inandnings- och utandningsslangarna, luftfuktaren med torrlinjeslangen, Y-kopplingen, trakealtuben och patientens lungor. Modellen är baserad på matematiska modeller som representerar systemets termodynamiska och pneumatiska beteende. Den är byggd i Simulink med existerande och anpassade block från Simscape. Jämfört med redan existerande simuleringsmodeller inkluderar denna modell gasens tröghetseffekter, vilket är avgörande när det gäller att noggrant modellera systemet samtidigt som det utsätts för snabba förändringar i flöde och tryck. För att utvärdera modellens prestanda jämförs det simulerade trycket och flödet vid patientporten med uppmätta data från en experimentell uppställning i labbmiljö. Resultaten från detta projekt visar att modellen är väldigt känslig för patientmodellen som används i simuleringsmiljön, vilket innebär att patientmodellen måste rekonstrueras för att uppnå en bättre prestanda för modellen. Jämfört med den redan existerande modellen som används för jämförelse i denna avhandling, syns det att en ökad parametermodell ger ett resultat närmare de uppmätta signalerna från det verkliga systemet.

Problématique : Les milieux cliniques ont généralement recours à des critères afin d’assurer l’éligibilité et la sécurité de la mobilisation précoce chez les patients mécaniquement ventilés à l’unité des soins intensifs (USI). Considérant que les protocoles de mobilisation et les critères neurologiques qui y sont associés sont peu définis malgré le fait que les altérations neurologiques soient courantes chez le patient ventilé, ce mémoire avait pour but d’investiguer les protocoles et les critères neurologiques qui peuvent être utilisés pour guider la mobilisation précoce à l’USI. Méthode : Les bases de données CINAHL, MEDLINE (OVID), PubMed, EMBASE, PsycINFO et Web of Science ont été explorées en septembre 2022 et 32 articles ont été retenus. La méthodologie d’une revue de la portée décrite par Arksey et O’Malley (2005) a été suivie en tenant pour compte des recommandations supplémentaires formulées par Levac et collaborateurs (2010). Le cadre de référence Knowledge to Action, pertinent à la génération et au transfert d’évidences en sciences infirmières, a permis de structurer la formulation des recommandations pour la pratique. Critères de sélection : adultes (> 18ans) sous ventilation mécanique, intervention de mobilisation précoce initiée dans les deux à cinq jours suivant l’admission à l’USI, énoncer clairement les critères neurologiques. Résultats : Concernant la mobilisation précoce, 24 écrits (75%) ont décrit un protocole progressif d’exercices pouvant s’adapter aux fluctuations de l’état neurologique du patient à l’USI, alors que huit autres (25%) se sont intéressés par une intervention unique pour assurer la mobilité de leurs patients. En regard des critères neurologiques recensés, ils ont été rassemblés sous deux catégories : 1) l’état de sédation-agitation et 2) l’état de conscience. La majorité des écrits (n=20, 63%) ont eu recours à une échelle validée afin de structurer l’évaluation de ces critères, notamment par le biais du Richmond Agitation-Sedation Scale (RASS) (n=16, 50%), de l’Échelle de coma de Glasgow (n=2, 6%) et du Ramsey Sedation Scale (RSS) (n=1, 3%). En revanche, 12 écrits (38%) n’ont pas eu recours à une échelle pour l’évaluation de ces critères. Conclusion : L’utilisation de protocoles pouvant s’adapter à l’état neurologique des patients ventilés mécaniquement en combinaison à des critères neurologiques pouvant être mesurés à l’aide d’échelle validée est recommandée pour encadrer la pratique de mobilisation précoce ainsi que pour promouvoir cette intervention à l’USI. Des études supplémentaires sont nécessaires pour comprendre l’impact de la mobilisation sur la récupération neurologique à l’USI. / Background. Clinical settings typically use criteria to ensure the eligibility and safety of early mobilization in mechanically ventilated patients in the intensive care unit (ICU). Considering that mobilization protocols and associated neurological criteria are poorly defined despite the prevalence of neurological impairments in ventilated patients, this study aimed to investigate the protocols and neurological criteria that can be used to guide early mobilization in the ICU. Methods. In September 2022, CINAHL, MEDLINE (OVID), PubMed, EMBASE, PsycINFO and Web of Science databases were explored, and the selection processes resulted in a final number of 32 articles. The methodology of a scoping review described by Arskey and O’Malley (2005) was followed, and the recommendations by Levac and al., (2010) were also taken into account. The Knowledge to Action framework, relevant to the transfer of evidence in nursing sciences, was used to formulate recommendations for the practice. Selection criteria. adults (>18 years old) under mechanical ventilation, early mobilization intervention initiated within 2-5 days following admission to the ICU, neurological criteria stated by authors Results. Regarding early mobilization, 24 authors (75%) suggested a progressive exercises protocol, while eight (25%) focused on the use of a device or single type of exercises. The neurological criteria are represented under two categories, the level of sedation-agitation and the level of consciousness. Among the reviewed articles, evaluation was structured with a validated scale for the majority (n=20, 63%), as the Richmond Agitation Sedation Scale (RASS) (n=16, 50%), the Glasgow Coma Scale (n=2, 6%) and the Ramsey Sedation Scale (RSS) (n=1, 3%) were used. Conclusion. The use of protocols adapted to the neurological status of mechanically ventilated patients, with the combinaison of neurological criteria defined by validated scale is recommended to guide practice and promote this intervention. Additional studies could be conducted to better understand the impact of mobilization in the neurological recovery in the ICU.