The Sara Combilize® as an early mobilisation aid for critically ill patients: A prospective before and after study

被引:20
作者
McWilliams, David [1 ]
Atkins, Gemma [1 ]
Hodson, James [2 ]
Snelson, Catherine [3 ]
机构
[1] Univ Hosp Birmingham NHS Fdn Trust, Therapy Serv, Mindelsohn Way, Birmingham B15 2WB, W Midlands, England
[2] Univ Hosp Birmingham NHS Fdn Trust, Mindelsohn Way, Birmingham B15 2WB, W Midlands, England
[3] Univ Hosp Birmingham NHS Fdn Trust, Crit Care, Mindelsohn Way, Birmingham B15 2WB, W Midlands, England
关键词
Critical care; ICU; Physiotherapy; Rehabilitation; Seating; Standing; INTENSIVE-CARE-UNIT; ACUTE RESPIRATORY-FAILURE; MECHANICALLY VENTILATED PATIENTS; QUALITY IMPROVEMENT PROJECT; CRITICAL ILLNESS; DISTRESS-SYNDROME; FOLLOW-UP; REHABILITATION; TRIAL; THERAPY;
D O I
10.1016/j.aucc.2016.09.001
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: Early mobility within the ICU is associated with a number of positive outcomes including reductions in ICU and hospital length of stay and better functional recovery. The exact definition of 'early' mobility is still not defined, with the actual ability to mobilise limited by a number of perceived factors. The Sara Combilize (R) is a combined tilt table and stretcher chair, which allows passive transfer of patients out of bed. This study aimed to assess whether the introduction of the Sara Combilize (R) reduced time taken to first mobilise for patients mechanically ventilated for at least five days and at risk of ICU acquired weakness. Methods: Patients admitted to a large UK critical care unit during the trial period and ventilated for >= 5 days were included in the study. Baseline data was collected prospectively for a period of four months. The Sara Combilize (R) was then introduced for a one month training and familiarisation period, followed by a further four months prospective data collection. The primary outcome was time to first mobilisation, defined as a Manchester Mobility Score >= 2. Results: Following the introduction of the Sara Combilizer, time taken to mobilise reduced significantly from 13.6 to 10.6 days (p = 0.028). SOFA scores were'significantly higher at the point of first mobilisation in the Combilizer group (mean: 2.9 +/- 0.5 vs. 5.1 +/- 2.4; p= 0.005). There was no statistical difference in therapy time between the groups, or ICU or hospital length of stay. Conclusions: The introduction of the Sara Combilize (R) was associated with a significant reduction in time to mobilise patients ventilated for >= 5 days, and patients were mobilised with a higher degree of organ failure. This was achieved without any increase in therapy time. The Sara Combilizer may be a useful adjunct to an early mobility protocol within the ICU. (C) 2016 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd.
引用
收藏
页码:189 / 195
页数:7
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