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Feasibility, safety, and resource utilisation of active mobilisation of patients on extracorporeal life support: a prospective observational study

BACKGROUND: There is scarce evidence on the feasibility, safety and resource utilisation of active mobilisation in critically ill patients on extracorporeal life support (ECLS). METHODS: This prospective observational single-centre study included all consecutive critically ill patients on ECLS admit...

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Autores principales: Braune, Stephan, Bojes, Patrick, Mecklenburg, Anne, Angriman, Federico, Soeffker, Gerold, Warnke, Katja, Westermann, Dirk, Blankenberg, Stefan, Kubik, Mathias, Reichenspurner, Hermann, Kluge, Stefan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7708587/
https://www.ncbi.nlm.nih.gov/pubmed/33259044
http://dx.doi.org/10.1186/s13613-020-00776-3
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author Braune, Stephan
Bojes, Patrick
Mecklenburg, Anne
Angriman, Federico
Soeffker, Gerold
Warnke, Katja
Westermann, Dirk
Blankenberg, Stefan
Kubik, Mathias
Reichenspurner, Hermann
Kluge, Stefan
author_facet Braune, Stephan
Bojes, Patrick
Mecklenburg, Anne
Angriman, Federico
Soeffker, Gerold
Warnke, Katja
Westermann, Dirk
Blankenberg, Stefan
Kubik, Mathias
Reichenspurner, Hermann
Kluge, Stefan
author_sort Braune, Stephan
collection PubMed
description BACKGROUND: There is scarce evidence on the feasibility, safety and resource utilisation of active mobilisation in critically ill patients on extracorporeal life support (ECLS). METHODS: This prospective observational single-centre study included all consecutive critically ill patients on ECLS admitted to an academic centre in Germany over a time period of one year. The level of mobilisation was categorised according to the ICU Mobility Scale (IMS). Primary outcome was complications during mobilisation. RESULTS: During the study period, active mobilisation with an activity level on the IMS of ≥ 3 was performed at least on one occasion in 43 out of 115 patients (37.4%). A total of 332 mobilisations with IMS ≥ 3 were performed during 1242 ECLS days (26.7%). ECLS configurations applied were va-ECMO (n = 63), vv-ECMO (n = 26), vv-ECCO(2)R (n = 12), av-ECCO(2)R (n = 10), and RVAD (n = 4). Femoral cannulation had been in place in 108 patients (93.9%). The median duration of all mobilisation activities with IMS ≥ 3 was 130 min (IQR 44–215). All mobilisations were undertaken by a multi-professional ECLS team with a median number of 3 team members involved (IQR 3–4). Bleeding from cannulation site requiring transfusion and/or surgery occurred in 6.9% of actively mobilised patients and in 15.3% of non-mobilised patients. During one mobilisation episode, accidental femoral cannula displacement occurred with immediate and effective recannulation. Sedation was the major reason for non-mobilisation. CONCLUSIONS: Active mobilisation (IMS ≥ 3) of ECLS patients undertaken by an experienced multi-professional team was feasible, and complications were infrequent and managed successfully. Larger prospective multicentre studies are needed to further evaluate early goal directed sedation and mobilisation bundles in patients on ECLS.
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spelling pubmed-77085872020-12-04 Feasibility, safety, and resource utilisation of active mobilisation of patients on extracorporeal life support: a prospective observational study Braune, Stephan Bojes, Patrick Mecklenburg, Anne Angriman, Federico Soeffker, Gerold Warnke, Katja Westermann, Dirk Blankenberg, Stefan Kubik, Mathias Reichenspurner, Hermann Kluge, Stefan Ann Intensive Care Research BACKGROUND: There is scarce evidence on the feasibility, safety and resource utilisation of active mobilisation in critically ill patients on extracorporeal life support (ECLS). METHODS: This prospective observational single-centre study included all consecutive critically ill patients on ECLS admitted to an academic centre in Germany over a time period of one year. The level of mobilisation was categorised according to the ICU Mobility Scale (IMS). Primary outcome was complications during mobilisation. RESULTS: During the study period, active mobilisation with an activity level on the IMS of ≥ 3 was performed at least on one occasion in 43 out of 115 patients (37.4%). A total of 332 mobilisations with IMS ≥ 3 were performed during 1242 ECLS days (26.7%). ECLS configurations applied were va-ECMO (n = 63), vv-ECMO (n = 26), vv-ECCO(2)R (n = 12), av-ECCO(2)R (n = 10), and RVAD (n = 4). Femoral cannulation had been in place in 108 patients (93.9%). The median duration of all mobilisation activities with IMS ≥ 3 was 130 min (IQR 44–215). All mobilisations were undertaken by a multi-professional ECLS team with a median number of 3 team members involved (IQR 3–4). Bleeding from cannulation site requiring transfusion and/or surgery occurred in 6.9% of actively mobilised patients and in 15.3% of non-mobilised patients. During one mobilisation episode, accidental femoral cannula displacement occurred with immediate and effective recannulation. Sedation was the major reason for non-mobilisation. CONCLUSIONS: Active mobilisation (IMS ≥ 3) of ECLS patients undertaken by an experienced multi-professional team was feasible, and complications were infrequent and managed successfully. Larger prospective multicentre studies are needed to further evaluate early goal directed sedation and mobilisation bundles in patients on ECLS. Springer International Publishing 2020-12-01 /pmc/articles/PMC7708587/ /pubmed/33259044 http://dx.doi.org/10.1186/s13613-020-00776-3 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Research
Braune, Stephan
Bojes, Patrick
Mecklenburg, Anne
Angriman, Federico
Soeffker, Gerold
Warnke, Katja
Westermann, Dirk
Blankenberg, Stefan
Kubik, Mathias
Reichenspurner, Hermann
Kluge, Stefan
Feasibility, safety, and resource utilisation of active mobilisation of patients on extracorporeal life support: a prospective observational study
title Feasibility, safety, and resource utilisation of active mobilisation of patients on extracorporeal life support: a prospective observational study
title_full Feasibility, safety, and resource utilisation of active mobilisation of patients on extracorporeal life support: a prospective observational study
title_fullStr Feasibility, safety, and resource utilisation of active mobilisation of patients on extracorporeal life support: a prospective observational study
title_full_unstemmed Feasibility, safety, and resource utilisation of active mobilisation of patients on extracorporeal life support: a prospective observational study
title_short Feasibility, safety, and resource utilisation of active mobilisation of patients on extracorporeal life support: a prospective observational study
title_sort feasibility, safety, and resource utilisation of active mobilisation of patients on extracorporeal life support: a prospective observational study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7708587/
https://www.ncbi.nlm.nih.gov/pubmed/33259044
http://dx.doi.org/10.1186/s13613-020-00776-3
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