Feasibility, safety, and resource utilisation of active mobilisation of patients on extracorporeal life support: a prospective observational study
Abstract 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 ECL...
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doaj-6e6baf6eb8d44b0fb3fedc03d5d9f3502020-12-06T12:32:10ZengSpringerOpenAnnals of Intensive Care2110-58202020-12-011011910.1186/s13613-020-00776-3Feasibility, safety, and resource utilisation of active mobilisation of patients on extracorporeal life support: a prospective observational studyStephan Braune0Patrick Bojes1Anne Mecklenburg2Federico Angriman3Gerold Soeffker4Katja Warnke5Dirk Westermann6Stefan Blankenberg7Mathias Kubik8Hermann Reichenspurner9Stefan Kluge10Department of Intensive Care Medicine, University Medical Center Hamburg-EppendorfDepartment of Intensive Care Medicine, University Medical Center Hamburg-EppendorfDepartment of Intensive Care Medicine, University Medical Center Hamburg-EppendorfInterdepartmental Division of Critical Care Medicine, Sunnybrook Health Sciences CentreDepartment of Intensive Care Medicine, University Medical Center Hamburg-EppendorfDepartment of Intensive Care Medicine, University Medical Center Hamburg-EppendorfDepartment of Interventional and General Cardiology, University Heart & Vascular Center HamburgDepartment of Interventional and General Cardiology, University Heart & Vascular Center HamburgDepartment of Intensive Care Medicine, University Medical Center Hamburg-EppendorfDepartment of Cardiovascular Surgery, University Heart & Vascular Center HamburgDepartment of Intensive Care Medicine, University Medical Center Hamburg-EppendorfAbstract 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-ECCO2R (n = 12), av-ECCO2R (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.https://doi.org/10.1186/s13613-020-00776-3MobilisationExtracorporeal life supportECLSECMOECCO2R |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Stephan Braune Patrick Bojes Anne Mecklenburg Federico Angriman Gerold Soeffker Katja Warnke Dirk Westermann Stefan Blankenberg Mathias Kubik Hermann Reichenspurner Stefan Kluge |
spellingShingle |
Stephan Braune Patrick Bojes Anne Mecklenburg Federico Angriman Gerold Soeffker Katja Warnke Dirk Westermann Stefan Blankenberg Mathias Kubik Hermann Reichenspurner Stefan Kluge Feasibility, safety, and resource utilisation of active mobilisation of patients on extracorporeal life support: a prospective observational study Annals of Intensive Care Mobilisation Extracorporeal life support ECLS ECMO ECCO2R |
author_facet |
Stephan Braune Patrick Bojes Anne Mecklenburg Federico Angriman Gerold Soeffker Katja Warnke Dirk Westermann Stefan Blankenberg Mathias Kubik Hermann Reichenspurner Stefan Kluge |
author_sort |
Stephan Braune |
title |
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_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_sort |
feasibility, safety, and resource utilisation of active mobilisation of patients on extracorporeal life support: a prospective observational study |
publisher |
SpringerOpen |
series |
Annals of Intensive Care |
issn |
2110-5820 |
publishDate |
2020-12-01 |
description |
Abstract 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-ECCO2R (n = 12), av-ECCO2R (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. |
topic |
Mobilisation Extracorporeal life support ECLS ECMO ECCO2R |
url |
https://doi.org/10.1186/s13613-020-00776-3 |
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