The following is a summary of “Robotic-Assisted In-Bed Mobilization in Ventilated ICU Patients With COVID-19: An Interventional, Randomized, Controlled Pilot Study (ROBEM II Study),” published in the May 2024 issue of Critical Care by Lorenz et al.
The surge of critically ill patients with COVID-19 constrained healthcare systems worldwide in their capacity to provide mechanical ventilation.
Researchers conducted a retrospective study to investigate whether robotic-assisted mobilization is feasible for patients with COVID-19.
They established four COVID-19 specialized ICUs at Charité-Universitätsmedizin Berlin (March 2021 to February 2022). Twenty critically ill patients with COVID-19 were anticipated to need more than 24 hours of ventilation. In comparison to standard care, a 5-day intervention phase included twice daily robotic-assisted mobilization sessions lasting 20 minutes or more, with follow-up at day 180.
The results showed that intervention sessions were conducted in 98.9% of cases according to protocol, with one session missing due to staff shortage. The primary outcome was the mobilization level measured with the ICU Mobility Scale (IMS) and Surgical ICU Optimal Mobilization Score (SOMS), assessed until day 5 or extubation. Safety events were recorded during mobilization. The median IMS and SOMS were 0 (0–0.16) and 1 (1–1.03) in the intervention group, and 0 (0–0.15) (P=0.77) and 0.8 (0.65–1.20) (P=0.08) in the standard care group, respectively. Significant secondary outcomes included an average of 8.5 [7.75–10] mobilization sessions in the intervention group compared to 4.5 [3.5–5] in the standard care group (P=0.001), a total mobilization time of 232.5 min [187.25–266.5 min] in the intervention group versus 147.5 min [107.5–167.5 min] in the standard care group (P=0.011), and 2 [2–2] healthcare providers per session in the intervention group compared to 1 [1–1.4] in the standard care group (P=0.001). Four safety events (hypertension and agitation, n = 2 each) were reported in the intervention group and none in the standard care group.
Investigators concluded that a pilot study found robotic-assisted mobilization safe and feasible for mechanically ventilated patients with COVID-19.