The critical scenario disease with immobility, physical deconditioning and hemodialysis (HD) has led to the implementation of physiotherapy aimed at early functional recovery and, as a result, a reduction in the length of hospital stays. However, barriers such as lack of knowledge and professional experience limit the implementation of physical therapy intra-dialytic assistance in the Intensive Care Unit (ICU) environment.

s: To summarize and present the evidence of adverse events of early physiotherapy applied to critically ill patients during hemodialysis in the ICU stay.

This was a scoping review carried out from May to July 2024, developed in accordance with the PRISMA-ScR guidelines. The Concept, Population, and Context strategy was used to develop research questions and carry out the literature search. Descriptors standardized by DECS and MESH in English and Portuguese were used, arranged in different strategies to maximize the search for results. The search was performed in the MEDLINE via PUBMED, EMBASE, LILACS-BVS, PEDro, Scielo, WoS, Portal de Periódicos CAPES, and CInaHL databases. The gray literature was consulted using Google Scholar. The studies were analyzed in terms of population, outcomes, and results. The main outcome was reported safety and the presence of adverse events during physiotherapy applied to critically ill patients during HD. Inclusion criteria were all experimental and observational studies and literature reviews available in full were included.

The evidence was published in 2016 to 2024. The population of these studies include adults in ICU stay that is performed intermittent or continuous HD. Physiotherapy applied in ICU stay was considered safe. The adverse events were minimal and may have hemodynamic transitory changes. By the way, there is no record of any specific adverse events directly related to physiotherapy. The results were also framed into seven themes on the particularities of early physiotherapy. The context of physiotherapy in the ICU, hemodialysis and vascular access to the necessary care, physiotherapy applied in the intra-dialytic period, the importance of multi-professional action, the recording of adverse events, and the patient's perception.

Early physiotherapy performed on critically ill patients during the hemodialysis period was considered safe and there are no specific adverse events directly related.

Although physiotherapy during hemodialysis in ICU is not associated with significant adverse events, the assistance must be performed by criteria assessment to promote safety and better practices. It is also necessary to break down cultural factors and personal beliefs of the team member, like inappropriate manipulation as well as prevent the loss of vascular access and improve therapeutic exercise knowledge on intra-dialytic period with the multi-professional experience.