Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study
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Published:2023-11-14
Issue:1
Volume:13
Page:
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ISSN:2110-5820
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Container-title:Annals of Intensive Care
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language:en
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Short-container-title:Ann. Intensive Care
Author:
Kloss PhilippORCID, Lindholz MaximilianORCID, Milnik AnnetteORCID, Azoulay ElieORCID, Cecconi MaurizioORCID, Citerio GiuseppeORCID, De Corte ThomasORCID, Duska FrantisekORCID, Galarza LauraORCID, Greco MassimilianoORCID, Girbes Armand R. J.ORCID, Kesecioglu JozefORCID, Mellinghoff JohannesORCID, Ostermann MarliesORCID, Pellegrini MariangelaORCID, Teboul Jean-LouisORCID, De Waele JanORCID, Wong AdrianORCID, Schaller Stefan J.ORCID, Aires Buenos, Gira Alicia, Eller Philipp, Hamid Tarikul, Haque Injamam Ull, De Buyser Wim, Cudia Antonella, De Backer Daniel, Foulon Pierre, Collin Vincent, Van Hecke Jolien, De Waele Elisabeth, Van Malderen Claire, Mesland Jean-Baptiste, Biston Patrick, Piagnerelli Michael, Haentjens Lionel, De Schryver Nicolas, Van Leemput Jan, Vanhove Philippe, Bulpa Pierre, Ilieva Viktoria, Katz David, Binnie Alexandra, Geagea Anna, Tirapegui Fernando, Lago Gustavo, Graf Jerónimo, Perez-Araos Rodrigo, Vargas Patricio, Martinez Felipe, Labarca Eduardo, Franco Daniel Molano, Parra-Tanoux Daniela, Yepes David, Hammouda Ahmed, Elmandouh Omar, Azzam Ahmed, Hussein Aliae Mohamed, Galal Islam, Awad Ahmed K., Azab Mohammed A., Abdalla Maged, Assal Hebatallah, Alfishawy Mostafa, Ghozy Sherief, Tharwat Samar, Eldaly Abdullah, Ellervee Anneli, Reinhard Veronika, Chrisment Anne, Poyat Chrystelle, Badie Julio, Berdaguer Ferrari Fernando, Weiss Björn, Schellenberg Clara, Grunow Julius J, Lorenz Marco, Schaller Stefan J, Spieth Peter, Bota Marc, Fichtner Falk, Fuest Kristina, Lahmer Tobias, Herrmann Johannes, Meybohm Patrick, Markou Nikolaos, Vasileiadou Georgia, Chrysanthopoulou Evangelia, Papamichalis Panagiotis, Soultati Ioanna, Jog Sameer, Kalvit Kushal, Nainan Myatra Sheila, Krupa Ivan, Tharwat Aisa, Nichol Alistair, McCarthy Aine, Mahmoodpoor Ata, Tonetti Tommaso, Isoni Paolo, Spadaro Savino, Volta Carlo Alberto, Mirabella Lucia, Noto Alberto, Florio Gaetano, Guzzardella Amedeo, Paleari Chiara, Baccanelli Federica, Savi Marzia, Antonelli Massimo, De Pascale Gennaro, Vaccarini Barbara, Montrucchio Giorgia, Sales Gabriele, Donadello Katia, Gottin Leonardo, Nizzero Marta, Polati Enrico, De Rosa Silvia, Sulemanji Demet, Abusalama Abdurraouf, Elhadi Muhammed, Jesus Montelongo Felipe De, Gonzalez Daniel Rodriguez, Robles Victor Hugo Madrigal, Canedo Nancy, Chavez Alejandro Esquivel, Dendane Tarek, Grady Bart, de Jong Ben, van der Heiden Eveline, Thoral Patrick, van den Bogaard Bas, Spronk Peter E., Achterberg Sefanja, Groeneveld Melanie, So Ralph K. L., de Wijs Calvin, Scholten Harm, Beishuizen Albertus, Cornet Alexander D., Reidinga Auke C., Kranen Hetty, Mensink Roos, den Boer Sylvia, de Groot Marcel, Beck Oliver, Bethlehem Carina, van Bussel Bas, Frenzel Tim, de Jong Celestine, Wilting Rob, Mehagnoul-Schipper Jannet, Alasia Datonye, Kumar Ashok, Qayyum Ahad, Rana Muhammad, Jayyab Mustafa Abu, Sierra Rosario Quispe, Hernandez Aaron Mark, Taborda Lúcia, Anselmo Mónica, Ramires Tiago, Silva Catarina, Roriz Carolina, Morais Rui, Póvoa Pedro, Patricio Patricia, Pinto André, Santos Maria Lurdes, Costa Vasco, Cunha Pedro, Gonçalves Celina, Nunes Sandra, Camões João, Adrião Diana, Oliveira Ana, Omrani Ali, Maslamani Muna Al, elbuzidi Abdurrahmaan Suei, qudah Bara Mahmoud Al, Akkari Abdel Rauof, Alkhatteb Mohamed, Baiou Anas, Husain Ahmed, Alwraidat Mohamed, Saif Ibrahim Abdulsalam, Bakdach Dana, Ahmed Amna, Aleef Mohamed, Bintaher Awadh, Petrisor Cristina, Popov Evgeniy, Popova Ksenia, Dementienko Mariia, Teplykh Boris, Pyregov Alexey, Davydova Liubov, Vladislav Belskii, Neporada Elena, Zverev Ivan, Meshchaninova Svetlana, Sokolov Dmitry, Gavrilova Elena, Shlyk Irina, Poliakov Igor, Vlasova Marina, Aljuhani Ohoud, Alkhalaf Amina, Humaid Felwa Bin, Arabi Yaseen, Kuhail Ahmed, Elrabi Omar, Ghannam Madihah E., Kansal Amit, Ho Vui Kian, Ng Jensen, García Raquel Rodrígez, Fraga Xiana Taboada, del Pilar García-Bonillo Mª, Padilla-Serrano Antonio, Cuadrado Marta Martin, Ferrando Carlos, Catalan-Monzon Ignacio, Frutos-Vivar Fernando, Jimenez Jorge, Rodríguez-Solis Carmen, Franquesa-Gonzalez Enric, Acosta Guillermo Pérez, Cabrera Luciano Santana, Parra Juan Pablo Aviles, Gonzalez Francisco Muñoyerro, del Carmen Conesa Maria Lorente, Varela Ignacio Yago Martinez, Pravia Orville Victoriano Baez, Delgado Maria Cruz Martin, de Cabo Carlos Munoz, Ioan Ana-Maria, Perez-Calvo Cesar, Santos Arnoldo, Abad-Motos Ane, Ripolles-Melchor Javier, Martin Belén Civantos, Teruel Santiago Yus, Lucas Juan Higuera, Ortiz Aaron Blandino, de Pablo Sánchez Raúl, Barrueco-Francioni Jesús Emilio, Espina Lorena Forcelledo, Bonell-Goytisolo José M., Salaverria Iñigo, Mir Antonia Socias, Rodriguez-Ruiz Emilio, Valverde Virginia Hidalgo, Cubero Patricia Jimeno, Linde Francisca Arbol, Leganes Nieves Cruza, Romeu Juan Maria, Concha Pablo, Berezo-Garcia José Angel, Fraile Virginia, Cuenca-Rubio Cristina, Pérez-Torres David, Serrano Ainhoa, Valero Clara Martínez, Suner Andrea Ortiz, Larrañaga Leire, Legaristi Noemi, Ferrigno Gerardo, Khlafalla Safa, Bihariesingh-Sanchit Rosita, Zoerner Frank, Grip Jonathan, Kilsand Kristina, Mårtensson Johan, Österlind Jonas, von Seth Magnus, Berkius Johan, Ceruti Samuele, Glotta Andrea, Izdes Seval, Turan Işıl Özkoçak, Cosar Ahmet, Halacli Burcin, Dereli Necla, Yilmaz Mehmet, Akbas Türkay, Elay Gülseren, Eyüpoğlu Selin, Bílír Yelíz, Saraçoğlu Kemal Tolga, Kaya Ebru, Sahin Ayca Sultan, Ekren Pervin Korkmaz, Mengi Tuğçe, Suner Kezban Ozmen, Tomak Yakup, Eroglu Ahmet, Alsabbah Asad, Hanlon Katie, Gervin Kevin, McMahon Sean, Hagan Samantha, Higenbottam Caroline V, Mullhi Randeep, Poulton Lottie, Torlinski Tomasz, Gareth Allen, Truman Nick, Vijayakumar Gopal, Hall Chris, Jubb Alasdair, Cagova Lenka, Jones Nicola, Graham Sam, Robin Nicole, Cowton Amanda, Donnelly Adrian, Singatullina Natalia, Kent Melanie, Boulanger Carole, Campbell Zoë, Potter Elizabeth, Duric Natalie, Szakmany Tamas, Kviatkovske Orinta, Marczin Nandor, Ellis Caroline, Saha Rajnish, Sri-Chandana Chunda, Allan John, Mumelj Lana, Venkatesh Harish, Gotz Vera Nina, Cochrane Anthony, Ficial Barbara, Kamble Shruthi, Lumlertgul Nuttha, Oddy Christopher, Jain Susan, Crapelli Giulia Beatrice, Vlachou Aikaterini, Golden David, Garrioch Sweyn, Henning Jeremy, Loveleena Gupta, Davey Miriam, Grauslyte Lina, Salciute-Simene Erika, Cook Martin, Barling Danny, Broadhurst Phil, Purvis Sarah, Spivey Michael, Shuker Benjamin, Grecu Irina, Harding Daniel, Singatullina Natalia, Dean James T., Nielsen Nathan D., Al-Bayati Sama, Al-Sadawi Mohammed, Charron Mariane, Stubenrauch Peter, Santanilla Jairo, Wentowski Catherine, Rosenberger Dorothea, Eksarko Polikseni, Jawa Randeep,
Abstract
Abstract
Background
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.
Methods
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.
Results
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; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 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; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates.
Conclusions
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.
Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021).
Funder
Technische Universität München
Publisher
Springer Science and Business Media LLC
Subject
Critical Care and Intensive Care Medicine
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