Early Rehabilitation for Patients with Septic Shock Associated with Mobilization During Their Intensive Care Unit Stay Without Worsening Mortality: A Multicenter, Prospective, Cohort Study.

IF 2.1 3区医学 Q2 CRITICAL CARE MEDICINE

Journal of Intensive Care Medicine Pub Date : 2025-07-04 DOI:10.1177/08850666251355211

Tasuku Hanajima, Yu Kawazoe, Takeshi Morimoto, Hitoshi Yamamura, Kyohei Miyamoto, Noriko Miyagawa, Yoshinori Ohta, Hideki Kanai, Tetsuya Kobayashi, Yoshiaki Tanabe, Tomonari Masuda, Yuichi Kataoka, Yasushi Asari

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引用次数: 0

Abstract

Objectives: Early rehabilitation of critically ill patients has been reported to have benefits such as recovery of physical function at the time of discharge and increasing ventilator-free days, but there is also a risk of increasing the mortality rate. Whether early rehabilitation for patients with septic shock is associated with mobilization during their intensive care unit (ICU) stay without worsening the survival rate was investigated.

Design: The Best Available Treatment for septic SHOCK (BEAT-SHOCK) registry was a multicenter, prospective, cohort study.

Setting: Twenty ICUs in Japan.

Patients: Patients with septic shock requiring high-dose norepinephrine (≥0.2 µg/kg/min) who were admitted to participating ICUs for more than 5 days from 2020 to 2022.

Interventions: Early rehabilitation within 48 h after ICU admission for patients with septic shock.

Measurements: The primary outcomes were sitting on the edge of the bed and standing within 14 days during the ICU stay, with secondary outcomes including 28-day mortality and 90-day mortality.

Main results: Of 268 patients, 156 underwent early rehabilitation. The early rehabilitation and no early rehabilitation groups had similar median ages (72 vs 73 years) and Acute Physiology And Chronic Health Evaluation II scores (28 vs 26). Early rehabilitation had a significant effect on sitting on the edge of the bed within 14 days after ICU admission (adjusted hazard ratio [aHR] 1.66; 95% confidence interval [CI] 1.15-2.39). It also had a significant effect on standing within 14 days after ICU admission (aHR 2.20; 95%CI 1.29-3.77). The 90-day mortality rate was similar between the groups (early rehabilitation group: 28%, no early rehabilitation group: 23%, P=0.51), with an aHR of 1.27 (95%CI 0.78-2.08).

Conclusion: Early rehabilitation for patients with septic shock was associated with mobilization during their ICU stay without worsening the survival rate.[Trial registration: UMIN clinical trial registry, UMIN000038302. Registered November 1, 2019, https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000043641].

查看原文本刊更多论文

脓毒性休克患者在重症监护病房住院期间进行早期康复治疗，避免死亡率恶化：一项多中心、前瞻性队列研究

目的：据报道，危重患者的早期康复具有诸如出院时身体功能恢复和增加无呼吸机天数等益处，但也有增加死亡率的风险。研究了脓毒性休克患者的早期康复是否与重症监护病房（ICU）期间的活动有关，而不影响生存率。设计：感染性休克的最佳可用治疗（BEAT-SHOCK）登记是一项多中心、前瞻性队列研究。设定：日本20个icu。患者：2020 - 2022年参与icu入住5天以上、需要大剂量去甲肾上腺素（≥0.2µg/kg/min）的脓毒性休克患者。干预措施：脓毒性休克患者入院后48小时内早期康复。测量方法：主要指标为患者在ICU住院14天内的床边坐位和站立，次要指标为28天死亡率和90天死亡率。主要结果：268例患者中，156例早期康复。早期康复组和未进行早期康复组的中位年龄（72岁vs 73岁）和急性生理和慢性健康评估II评分（28分vs 26分）相似。入院后14天内，早期康复对患者床边坐位有显著影响(校正风险比[aHR] 1.66；95%置信区间[CI] 1.15-2.39)。它对ICU入院后14天内站立也有显著影响(aHR 2.20；95%可信区间1.29 - -3.77)。两组90天死亡率相似（早期康复组：28%，未早期康复组：23%，P=0.51）， aHR为1.27 （95%CI 0.78 ~ 2.08）。结论：脓毒性休克患者的早期康复与ICU住院期间的活动有关，且不影响生存率。[试验注册：UMIN临床试验注册，UMIN000038302。]2019年11月1日报名，https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000043641]。

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来源期刊

Journal of Intensive Care Medicine CRITICAL CARE MEDICINE-

CiteScore

7.60

自引率

3.20%

发文量

107

期刊介绍： Journal of Intensive Care Medicine (JIC) is a peer-reviewed bi-monthly journal offering medical and surgical clinicians in adult and pediatric intensive care state-of-the-art, broad-based analytic reviews and updates, original articles, reports of large clinical series, techniques and procedures, topic-specific electronic resources, book reviews, and editorials on all aspects of intensive/critical/coronary care.