Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study

Medientyp: E-Artikel
Titel: Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study
Beteiligte: Kloss, Philipp; Lindholz, Maximilian; Milnik, Annette; Azoulay, Elie; Cecconi, Maurizio; Citerio, Giuseppe; De Corte, Thomas; Duska, Frantisek; Galarza, Laura; Greco, Massimiliano; Girbes, Armand R. J.; Kesecioglu, Jozef; Mellinghoff, Johannes; Ostermann, Marlies; Pellegrini, Mariangela; Teboul, Jean-Louis; De Waele, Jan; Wong, Adrian; Schaller, Stefan J.; Aires, Buenos; Gira, Alicia; Eller, Philipp; Hamid, Tarikul; Haque, Injamam Ull; [...]
Erschienen: Springer Science and Business Media LLC, 2023
Erschienen in: Annals of Intensive Care
Sprache: Englisch
DOI: 10.1186/s13613-023-01201-1
ISSN: 2110-5820
Schlagwörter: Critical Care and Intensive Care Medicine
Entstehung:
Anmerkungen:
Beschreibung: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; <jats:italic>p</jats:italic> = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; <jats:italic>p</jats:italic> ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; <jats:italic>p</jats:italic> = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; <jats:italic>p</jats:italic> = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; <jats:italic>p</jats:italic> = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37,<jats:italic> p</jats:italic> = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35,<jats:italic> p</jats:italic> = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, <jats:italic>p</jats:italic> = 0.24) when adjusted for covariates.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility.</jats:p> <jats:p><jats:italic>Trial registration</jats:italic> ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021).</jats:p> </jats:sec>
Zugangsstatus: Freier Zugang

Nur in Feld suchen:

Zuletzt gesuchte Begriffe: