Marco Lorenz , Nadine Langer , Philipp Kloss , Mathilde Maechler , Annika Bald , Linus Warner , Kristina Fuest , Björn Weiß , Stefan J. Schaller
{"title":"机器人辅助通气外科危重患者早期活动(ROBEM-I)——一项随机、对照、结果评估、盲法的试点研究。","authors":"Marco Lorenz , Nadine Langer , Philipp Kloss , Mathilde Maechler , Annika Bald , Linus Warner , Kristina Fuest , Björn Weiß , Stefan J. Schaller","doi":"10.1016/j.accpm.2025.101549","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>A shortage of human resources is a key barrier to the early mobilization of mechanically ventilated ICU patients. Recent advancements in robotic mobilization systems offer promising solutions to this challenge.</div></div><div><h3>Objective(s)</h3><div>This study assessed the operability of an AI-assisted robotic mobilization system by a single healthcare provider, along with its safety, feasibility, and potential benefits for mechanically ventilated surgical ICU patients.</div></div><div><h3>Design</h3><div>Randomized controlled pilot study.</div></div><div><h3>Setting</h3><div>Five surgical ICUs at Charité – Universitätsmedizin Berlin, Germany, November 2020 to September 2022.</div></div><div><h3>Patients</h3><div>Twenty critically ill patients requiring >24 h of mechanical ventilation.</div></div><div><h3>Intervention(s)</h3><div>Twice-daily robotic-assisted mobilization sessions ≥ 20 min over five days, compared to the control group receiving standard care.</div></div><div><h3>Main outcome measures</h3><div>Number of mobilization sessions conducted by a single person.</div></div><div><h3>Results</h3><div>In the robotic-assisted group, no mobility sessions were conducted by a single person (0%) <em>vs.</em> 26 (96%) in the control group (<em>p</em> < 0.001). Significant secondary outcomes included a mobilization duration of 41 min/day [IQR 36–47] in the intervention group <em>vs.</em> 19 min/day [IQR 13–21] in the control group (<em>p</em> < 0.001) and higher mobilization frequency, with two units/day [IQR 2−2] in the intervention group <em>vs.</em> 0.9 units/day [IQR 0.7–1.0] in the control group (<em>p</em> < 0.001). Interleukin-6 levels decreased significantly by −4.65 pg/mL [IQR −13.00–3.83] in the intervention group <em>vs.</em> an increase of 3.70 pg/ml [IQR −1.30–28.88] in the control group (<em>p</em> = 0.049).</div></div><div><h3>Conclusions</h3><div>Robotic-assisted mobilization in mechanically ventilated critically ill patients did not reduce required healthcare providers but increased the duration and frequency, and significantly reduced IL-6 levels compared to the standard group.</div></div><div><h3>Trial registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, registration number <span><span>NCT04423796</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 4","pages":"Article 101549"},"PeriodicalIF":4.7000,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"ROBotic-assisted Early Mobilization in ventilated surgical critically ill patients (ROBEM-I)—A randomized, controlled, outcome-assessor-blinded pilot study\",\"authors\":\"Marco Lorenz , Nadine Langer , Philipp Kloss , Mathilde Maechler , Annika Bald , Linus Warner , Kristina Fuest , Björn Weiß , Stefan J. Schaller\",\"doi\":\"10.1016/j.accpm.2025.101549\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>A shortage of human resources is a key barrier to the early mobilization of mechanically ventilated ICU patients. Recent advancements in robotic mobilization systems offer promising solutions to this challenge.</div></div><div><h3>Objective(s)</h3><div>This study assessed the operability of an AI-assisted robotic mobilization system by a single healthcare provider, along with its safety, feasibility, and potential benefits for mechanically ventilated surgical ICU patients.</div></div><div><h3>Design</h3><div>Randomized controlled pilot study.</div></div><div><h3>Setting</h3><div>Five surgical ICUs at Charité – Universitätsmedizin Berlin, Germany, November 2020 to September 2022.</div></div><div><h3>Patients</h3><div>Twenty critically ill patients requiring >24 h of mechanical ventilation.</div></div><div><h3>Intervention(s)</h3><div>Twice-daily robotic-assisted mobilization sessions ≥ 20 min over five days, compared to the control group receiving standard care.</div></div><div><h3>Main outcome measures</h3><div>Number of mobilization sessions conducted by a single person.</div></div><div><h3>Results</h3><div>In the robotic-assisted group, no mobility sessions were conducted by a single person (0%) <em>vs.</em> 26 (96%) in the control group (<em>p</em> < 0.001). Significant secondary outcomes included a mobilization duration of 41 min/day [IQR 36–47] in the intervention group <em>vs.</em> 19 min/day [IQR 13–21] in the control group (<em>p</em> < 0.001) and higher mobilization frequency, with two units/day [IQR 2−2] in the intervention group <em>vs.</em> 0.9 units/day [IQR 0.7–1.0] in the control group (<em>p</em> < 0.001). Interleukin-6 levels decreased significantly by −4.65 pg/mL [IQR −13.00–3.83] in the intervention group <em>vs.</em> an increase of 3.70 pg/ml [IQR −1.30–28.88] in the control group (<em>p</em> = 0.049).</div></div><div><h3>Conclusions</h3><div>Robotic-assisted mobilization in mechanically ventilated critically ill patients did not reduce required healthcare providers but increased the duration and frequency, and significantly reduced IL-6 levels compared to the standard group.</div></div><div><h3>Trial registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, registration number <span><span>NCT04423796</span><svg><path></path></svg></span>.</div></div>\",\"PeriodicalId\":48762,\"journal\":{\"name\":\"Anaesthesia Critical Care & Pain Medicine\",\"volume\":\"44 4\",\"pages\":\"Article 101549\"},\"PeriodicalIF\":4.7000,\"publicationDate\":\"2025-05-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Anaesthesia Critical Care & Pain Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2352556825000815\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anaesthesia Critical Care & Pain Medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2352556825000815","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
ROBotic-assisted Early Mobilization in ventilated surgical critically ill patients (ROBEM-I)—A randomized, controlled, outcome-assessor-blinded pilot study
Background
A shortage of human resources is a key barrier to the early mobilization of mechanically ventilated ICU patients. Recent advancements in robotic mobilization systems offer promising solutions to this challenge.
Objective(s)
This study assessed the operability of an AI-assisted robotic mobilization system by a single healthcare provider, along with its safety, feasibility, and potential benefits for mechanically ventilated surgical ICU patients.
Design
Randomized controlled pilot study.
Setting
Five surgical ICUs at Charité – Universitätsmedizin Berlin, Germany, November 2020 to September 2022.
Patients
Twenty critically ill patients requiring >24 h of mechanical ventilation.
Intervention(s)
Twice-daily robotic-assisted mobilization sessions ≥ 20 min over five days, compared to the control group receiving standard care.
Main outcome measures
Number of mobilization sessions conducted by a single person.
Results
In the robotic-assisted group, no mobility sessions were conducted by a single person (0%) vs. 26 (96%) in the control group (p < 0.001). Significant secondary outcomes included a mobilization duration of 41 min/day [IQR 36–47] in the intervention group vs. 19 min/day [IQR 13–21] in the control group (p < 0.001) and higher mobilization frequency, with two units/day [IQR 2−2] in the intervention group vs. 0.9 units/day [IQR 0.7–1.0] in the control group (p < 0.001). Interleukin-6 levels decreased significantly by −4.65 pg/mL [IQR −13.00–3.83] in the intervention group vs. an increase of 3.70 pg/ml [IQR −1.30–28.88] in the control group (p = 0.049).
Conclusions
Robotic-assisted mobilization in mechanically ventilated critically ill patients did not reduce required healthcare providers but increased the duration and frequency, and significantly reduced IL-6 levels compared to the standard group.
Trial registration
ClinicalTrials.gov, registration number NCT04423796.
期刊介绍:
Anaesthesia, Critical Care & Pain Medicine (formerly Annales Françaises d''Anesthésie et de Réanimation) publishes in English the highest quality original material, both scientific and clinical, on all aspects of anaesthesia, critical care & pain medicine.