title: The Sara Combilizer®as an early mobilisation aid for critically ill patients: A prospective before and after study.
abstract: BACKGROUND
  Early mobility within the ICU is associated with a number of positive outcomes including reductions in ICU and hospital length of stay and better functional recovery. The exact definition of 'early' mobility is still not defined, with the actual ability to mobilise limited by a number of perceived factors. The Sara Combilizer®is a combined tilt table and stretcher chair, which allows passive transfer of patients out of bed. This study aimed to assess whether the introduction of the Sara Combilizer®reduced time taken to first mobilise for patients mechanically ventilated for at least five days and at risk of ICU acquired weakness.
  
  
  METHODS
  Patients admitted to a large UK critical care unit during the trial period and ventilated for ≥5days were included in the study. Baseline data was collected prospectively for a period of four months. The Sara Combilizer®was then introduced for a one month training and familiarisation period, followed by a further four months prospective data collection. The primary outcome was time to first mobilisation, defined as a Manchester Mobility Score ≥2.
  
  
  RESULTS
  Following the introduction of the Sara Combilizer®, time taken to mobilise reduced significantly from 13.6 to 10.6days (p=0.028). SOFA scores were significantly higher at the point of first mobilisation in the Combilizer group (mean: 2.9±0.5 vs. 5.1±2.4; p=0.005). There was no statistical difference in therapy time between the groups, or ICU or hospital length of stay.
  
  
  CONCLUSIONS
  The introduction of the Sara Combilizer®was associated with a significant reduction in time to mobilise patients ventilated for ≥5days, and patients were mobilised with a higher degree of organ failure. This was achieved without any increase in therapy time. The Sara Combilizer®may be a useful adjunct to an early mobility protocol within the ICU.
authors.affiliation: Therapy Services, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, United Kingdom. Electronic address: David.Mcwilliams@uhb.nhs.uk.
authors.forename: David
authors.initials: D
authors.lastname: McWilliams
authors.affiliation: Therapy Services, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, United Kingdom.
authors.forename: Gemma
authors.initials: G
authors.lastname: Atkins
authors.affiliation: Medical Statistician, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, United Kingdom.
authors.forename: James
authors.initials: J
authors.lastname: Hodson
authors.affiliation: Critical Care, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, United Kingdom.
authors.forename: Catherine
authors.initials: C
authors.lastname: Snelson
mesh_terms: D016638:Critical Illness; D004434:Early Ambulation / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D055805:Moving and Lifting Patients / Q000295:instrumentation*; D011446:Prospective Studies; D012121:Respiration, Artificial; D006113:United Kingdom
keywords: Critical care; ICU; Physiotherapy; Rehabilitation; Seating; Standing