dc.contributor.author
Lindholz, Maximilian
dc.contributor.author
Schellenberg, Clara M.
dc.contributor.author
Grunow, Julius J.
dc.contributor.author
Kagerbauer, Simone
dc.contributor.author
Milnik, Annette
dc.contributor.author
Zickler, Daniel
dc.contributor.author
Angermair, Stefan
dc.contributor.author
Reißhauer, Anett
dc.contributor.author
Witzenrath, Martin
dc.contributor.author
Menk, Mario
dc.contributor.author
Boie, Sebastian
dc.contributor.author
Balzer, Felix
dc.contributor.author
Schaller, Stefan J.
dc.date.accessioned
2023-12-05T16:56:01Z
dc.date.available
2023-12-05T16:56:01Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/41760
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-41480
dc.description.abstract
Background: Mobilisation and exercise intervention in general are safe and feasible in critically ill patients. For patients requiring catecholamines, however, doses of norepinephrine safe for mobilisation in the intensive care unit (ICU) are not defined. This study aimed to describe mobilisation practice in our hospital and identify doses of norepinephrine that allowed a safe mobilisation.
Methods: We conducted a retrospective single-centre cohort study of 16 ICUs at a university hospital in Germany with patients admitted between March 2018 and November 2021. Data were collected from our patient data management system. We analysed the effect of norepinephrine on level (ICU Mobility Scale) and frequency (units per day) of mobilisation, early mobilisation (within 72 h of ICU admission), mortality, and rate of adverse events. Data were extracted from free-text mobilisation entries using supervised machine learning (support vector machine). Statistical analyses were done using (generalised) linear (mixed-effect) models, as well as chi-square tests and ANOVAs.
Results: A total of 12,462 patients were analysed in this study. They received a total of 59,415 mobilisation units. Of these patients, 842 (6.8%) received mobilisation under continuous norepinephrine administration. Norepinephrine administration was negatively associated with the frequency of mobilisation (adjusted difference -0.07 mobilisations per day; 95% CI - 0.09, - 0.05; p <= 0.001) and early mobilisation (adjusted OR 0.83; 95% CI 0.76, 0.90; p <= 0.001), while a higher norepinephrine dose corresponded to a lower chance to be mobilised out-of-bed (adjusted OR 0.01; 95% CI 0.00, 0.04; p <= 0.001). Mobilisation with norepinephrine did not significantly affect mortality (p > 0.1). Higher compared to lower doses of norepinephrine did not lead to a significant increase in adverse events in our practice (p > 0.1). We identified that mobilisation was safe with up to 0.20 mu g/kg/min norepinephrine for out-of-bed (IMS >= 2) and 0.33 mu g/kg/min for in-bed (IMS 0-1) mobilisation.
Conclusions: Mobilisation with norepinephrine can be done safely when considering the status of the patient and safety guidelines. We demonstrated that safe mobilisation was possible with norepinephrine doses up to 0.20 mu g/kg/min for out-of-bed (IMS >= 2) and 0.33 mu g/kg/min for in-bed (IMS 0-1) mobilisation.
en
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
Early mobilisation
en
dc.subject
Early ambulation
en
dc.subject
Norepinephrine
en
dc.subject
Adverse events
en
dc.subject
Supervised machine learning
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Mobilisation of critically ill patients receiving norepinephrine: a retrospective cohort study
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.articlenumber
362
dcterms.bibliographicCitation.doi
10.1186/s13054-022-04245-0
dcterms.bibliographicCitation.journaltitle
Critical Care
dcterms.bibliographicCitation.number
1
dcterms.bibliographicCitation.originalpublishername
Springer Nature
dcterms.bibliographicCitation.volume
26
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.funding
Springer Nature DEAL
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
36434724
dcterms.isPartOf.eissn
1364-8535