The Sara Combilizer ® as an early mobilisation aid for critically ill patients: A prospective before and after study

Background: Early mobility within the ICU is associated with a number of positive outcomes includingreductions 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 patientsout of bed. This study aimed to assess whether the introduction of the Sara Combilizer®reduced timetaken to first mobilise for patients mechanically ventilated for at least five days and at risk of ICU acquiredweakness.

Methods: Patients admitted to a large UK critical care unit during the trial period and ventilated for ≥5 dayswere included in the study. Baseline data was collected prospectively for a period of four months. TheSara Combilizer®was then introduced for a one month training and familiarisation period, followed bya 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 significantlyfrom 13.6 to 10.6 days (p = 0.028). SOFA scores were significantly higher at the point of first mobilisationin the Combilizer group (mean: 2.9 ± 0.5 vs. 5.1 ± 2.4; p = 0.005). There was no statistical difference intherapy 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 timeto mobilise patients ventilated for ≥5 days, and patients were mobilised with a higher degree of organfailure. This was achieved without any increase in therapy time. The Sara Combilizer®may be a usefuladjunct to an early mobility protocol within the ICU