Mobilisation practices during the SARS-CoV-2 pandemic: A retrospective analysis (MobiCOVID)

Schellenberg, Clara M.; Lindholz, Maximilian; Grunow, Julius J.; Boie, Sebastian; Bald, A; Warner, Laura; Ulm, Bernhard; Milnik, Annette; Zickler, Daniel; Angermair, Stefan; Reißhauer, Anett; Witzenrath, Martin; Menk, Mario; Balzer, Felix; Ocker, Thomas; Weber‐Carstens, Steffen; Schaller, Stefan J.

doi:10.1016/j.accpm.2023.101255

Cited by 4 publications

(2 citation statements)

References 36 publications

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“…We can speculate that this continuous training may partially explain the similar mortality rates between Expert-ICU and New-ICU in our study and the comparable reduction in adjusted mortality rate over time. For example, Schellenberg et al reported that surge ICUs did not display lower rates of early mobilization thanks to the training and educational efforts of surge ICU managers [27].…”

Section: Staff Experience and Trainingmentioning

confidence: 99%

Management and outcomes of COVID-19 patients admitted in a newly created ICU and an expert ICU, a retrospective observational study

Aarab,

Debourdeau,

Garnier

et al. 2024

Anaesthesia Critical Care & Pain Medicine

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Section: Staff Experience and Trainingmentioning

confidence: 99%

Management and outcomes of COVID-19 patients admitted in a newly created ICU and an expert ICU, a retrospective observational study

Aarab,

Debourdeau,

Garnier

et al. 2024

Anaesthesia Critical Care & Pain Medicine

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“…Extensive research has focused on understanding SARS-CoV-2 (severe acute respiratory syndrome coronavirus type), including its progression, therapeutic targets and potential prognostic factors [ 1 ]. Approximately 10–15% of patients with SARS-CoV-2 require hospitalization, of which 20–30% develop life-threatening manifestations such as acute respiratory distress syndrome (ARDS) necessitating intensive care unit (ICU) treatment [ 1 – 3 ]. Despite recent advances, ICU mortality in these patients remains high, varying from 20% to more than 50% depending on various factors such as geographical location, demographic characteristics, and underlying health conditions [ 4 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Nucleated red blood cells as a prognostic marker for mortality in patients with SARS-CoV-2-induced ARDS: an observational study

Kirsch,

Niebhagen,

Goldammer

et al. 2024

J Anesth Analg Crit Care

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Background The presence of nucleated red blood cells (NRBCs) in the peripheral blood of critically ill patients is associated with poor outcome. Evidence regarding the predictive value of NRBCs in patients with SARS-CoV-2-induced acute respiratory distress syndrome (ARDS) remains elusive. The aim of this study was to evaluate the predictive validity of NRBCs in these patients. Methods Daily NRBC values of adult patients with SARS-CoV-2-induced ARDS were assessed and their predictive validity for mortality was statistically evaluated. A cut-off level based on the patient’s maximum NRBC value during ICU stay was calculated and further specified according to Youden’s method. Based on this cut-off value, further analyses such as logistic regression models and survival were performed. Results 413 critically ill patients with SARS-CoV-2-induced ARDS were analyzed. Patients who did not survive had significantly higher NRBC values during their ICU stay compared to patients who survived (1090/µl [310; 3883] vs. 140/µl [20; 500]; p < 0.0001). Patients with severe ARDS (n = 374) had significantly higher NRBC values during ICU stay compared to patients with moderate ARDS (n = 38) (490/µl [120; 1890] vs. 30/µl [10; 476]; p < 0.0001). A cut-off level of NRBC ≥ 500/µl was found to best stratify risk and was associated with a longer duration of ICU stay (12 [8; 18] vs. 18 [13; 27] days; p < 0.0001) and longer duration of mechanical ventilation (10 [6; 16] vs. 17 [12; 26] days; p < 0.0001). Logistic regression analysis with multivariate adjustment showed NRBCs ≥ 500/µl to be an independent risk factor of mortality (odds ratio (OR) 4.72; 95% confidence interval (CI) 2.95–7.62, p < 0.0001). Patients with NRBC values below the threshold of 500/µl had a significant survival advantage over those above the threshold (median survival 32 [95% CI 8.7–43.3] vs. 21 days [95% CI 18.2–23.8], log-rank test, p < 0.05). Patients who once reached the NRBC threshold of ≥ 500/µl during their ICU stay had a significantly increased long-term mortality (median survival 489 days, log-rank test, p = 0.0029, hazard ratio (HR) 3.2, 95% CI 1.2–8.5). Conclusions NRBCs predict mortality in critically ill patients with SARS-CoV-2-induced ARDS with high prognostic power. Further studies are required to confirm the clinical impact of NRBCs to eventually enhance decision making.

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Robotic-Assisted In-Bed Mobilization in Ventilated ICU Patients With COVID-19: An Interventional, Randomized, Controlled Pilot Study (ROBEM II Study)*

Lorenz,

Baum,

Kloss

et al. 2024

Critical Care Medicine

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Objectives: The COVID-19 pandemic significantly impacted global healthcare systems, particularly in managing critically ill mechanically ventilated patients. This study aims to assess the feasibility of robotic-assisted mobilization in COVID-19 patients. Design: Randomized controlled pilot study. Setting: Four COVID-19 specialized ICUs at Charité-Universitätsmedizin Berlin (March 2021 to February 2022). Patients: Twenty critically ill COVID-19 patients expected to require greater than 24 hours of ventilation. Interventions: A 5-day intervention phase with bid robotic-assisted mobilization greater than or equal to 20 minutes and follow-up at day 180, compared with standard care. Measurements and Main Results: Intervention sessions were conducted in 98.9% according to protocol, with one session missing due to staff shortage. Primary outcome was the mobilization level measured with the ICU Mobility Scale (IMS) and Surgical ICU Optimal Mobilization Score (SOMS), assessed until day 5 or extubation. Safety events were recorded during mobilization. The median IMS and SOMS were 0 (0–0.16) and 1 (1–1.03) in the intervention group, and 0 (0–0.15) (p = 0.77) and 0.8 (0.65–1.20) (p = 0.08) in the standard care group, respectively. Significant secondary outcomes included average number of mobilization sessions (intervention: 8.5 [7.75–10] vs. standard care: 4.5 [3.5–5]; p = 0.001), total mobilization time (intervention: 232.5 min [187.25–266.5 min] vs. standard care: 147.5 min [107.5–167.5 min]; p = 0.011), and healthcare providers per session (intervention: 2 [2–2] vs. standard care: 1 [1–1.4]; p = 0.001) during intervention. Four safety events (hypertension and agitation, n = 2 each) in the intervention group and none in the standard care group were reported. Conclusions: Robotic-assisted mobilization in mechanically ventilated COVID-19 patients appears to be safe and feasible.

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Mobilisation practices during the SARS-CoV-2 pandemic: A retrospective analysis (MobiCOVID)

Cited by 4 publications

References 36 publications

Management and outcomes of COVID-19 patients admitted in a newly created ICU and an expert ICU, a retrospective observational study

Management and outcomes of COVID-19 patients admitted in a newly created ICU and an expert ICU, a retrospective observational study

Nucleated red blood cells as a prognostic marker for mortality in patients with SARS-CoV-2-induced ARDS: an observational study

Robotic-Assisted In-Bed Mobilization in Ventilated ICU Patients With COVID-19: An Interventional, Randomized, Controlled Pilot Study (ROBEM II Study)*

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