Zusammenfassung
(Früh-)Mobilisation ist ein wichtiges Element auf der Intensivstation – es dient der
Prävention und Therapie der durch eine kritische Erkrankung verursachten Einschränkungen
der körperlichen Funktion. Aufgrund diverser Barrieren werden die aktuellen Leitlinien-Ziele
aber nicht immer erreicht. In diesem Beitrag geht es um die Integration des Intensivpflegezimmers
und moderner Medizintechnik in die Frühmobilisation zur Überwindung dieser Barrieren.
Abstract
Intensive Care Unit patients frequently develop physical impairments, mainly weakness,
during their ICU stay. Early mobilization is a central therapeutic element in patients
on an intensive care unit to prevent and treat these physical sequelae to conserve
independence. Different barriers such as lacking patient motivation, insufficient
staffing and fear of dislocating vascular access or the airway led to insufficient
implementation of current guideline recommendation. Integration of modern medical
equipment as well as the adequate ICU room concepts is a promising option to overcome
those barriers.
Allowing for sufficient free floor area when planning an ICU – maybe through the integration
of mobile elements – is likely to ease early mobilization and should be thoroughly
considered when building or remodeling an ICU. Furthermore, wireless monitoring has
been deemed necessary and could potentially decrease the fear regarding dislocation
due to less cable or lines that need to be managed during mobilization.
Virtual reality is a rapidly evolving field and while in ICU patients it could so
far only show to reduce stress level it has been shown to improve rehabilitation in
stroke patients. It is imaginable that its integration in mobilization on the ICU
will boost patientsʼ motivation. Trials are still outstanding.
Robotics integrated in the ICU bed or in form of exoskeletons are currently being
piloted in critically ill patients with many expected benefits due to the ability
to support patients tailored to their individual needs, reduce staff requirements
as the robotics will cover support function and improved duration and intensity of
mobilization as for example the patient can be ambulated without ever leaving the
bed, which also translates into potentially reduced fear regarding dislocation of
the airway or vascular access.
Currently, evidence on the benefits regarding the integration of ICU rooms as well
as modern medical technology into the process of (early) mobilization is lacking but
especially in the sector of robotics a huge potential is to be suspected.
Schlüsselwörter
Behandlungszimmer - Exoskelett - (Früh-)Mobilisation - Robotik - Virtual Reality
Key words
early ambulation - robotics - virtual reality - exoskeletons - ICU concepts
