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Zusammenfassung: Hintergrund: Intensivpatient_innen sind oft einer langen Immobilität ausgesetzt. Wenn sie aber frühzeitig mobilisiert werden, lassen sich positive Effekte auf ihr Outcome, wie z.B. eine Verbesserung der körperlichen Funktion, nachweisen. Einer der Gründe für die späte Mobilisation ist, dass zu wenig Hilfsmittel zur Verfügung stehen. Fragestellungen/Ziel: Dieser Beitrag gibt einen Überblick über den Einsatz von robotischen oder technischen Systemen als Hilfsmittel für die Frühmobilisation. Welche robotischen und technischen Hilfsmittel werden in Studien zur Frühmobilisation von erwachsenen Intensivpatient_innen durch Pflegefachpersonen oder Physiotherapeut_innen untersucht? Über welche Effekte von Frühmobilisation mittels robotischem und technischem System auf die Patientenoutcomes wird in den Studien berichtet? Methoden: Die Datenbanken Medline, Web of Science, CINAHL, Cochrane Library, Embase, IEEE Xplore, Scopus und WTI wurden zwischen Mai und Juli 2020 und im Januar 2022 systematisch durchsucht. Zusätzlich wurde im ersten Suchlauf eine Randsuche über GoogleScolar und ResearchGate durchgeführt. Ergebnisse: Es wurden 27 Veröffentlichungen eingeschlossen (9 RCTs, 7 Expertenmeinungen, 3 quantitative Querschnittstudien, 2 Fall-Kontroll-Studien, 2 Literaturreviews, 2 klinische Einzelfallstudien, 2 Interventionsstudien im Prä-Post-Design). Hier zeigte sich, dass als Hilfsmittel vor allem elektronische Bettfahrräder und Kipptische eingesetzt werden. Es war eine uneinheitliche Datenlage in Bezug auf verschiedene Patientenoutcomes nachweisbar. Schlussfolgerungen: Weitere Forschung zum Einsatz von technischen und robotischen Systemen zur Frühmobilisation ist vor allem in Bezug auf unterschiedliche Studienpopulationen notwendig. Frühmobilisationsrobotik ist noch nicht Teil der Regelversorgung.

Background Post-COVID-Fatigue (PCF) is one of the most reported symptoms following SARS-CoV-2 infection. Currently, research on persistent symptoms focuses mainly on severe infections, while outpatients are rarely included in observations. Objective To investigate whether the severity of PCF is related to the number of acute and persistent symptoms due to mild-to-moderate COVID-19 and to compare the most common symptoms during acute infection with the persistent symptoms in PCF patients. Methods A total of 425 participants were examined after COVID-19 treated as an outpatient (median 249 days [IQR: 135; 322] after acute disease) at the site of University Hospital Augsburg, Germany. The Fatigue Assessment Scale (FAS) was used to quantify the severity of PCF. The number of symptoms (maximum 41) during acute infection and persistent symptoms (during the last 14 days before examination) were added up to sum scores. Multivariable linear regression models were used to show the association between the number of symptoms and PCF. Results Of the 425 participants, 37% (n = 157) developed PCF; most were women (70%). The median number of symptoms was significantly higher in the PCF group than in the non-PCF group at both time points. In multivariable linear regression models, both sum scores were associated with PCF (acute symptoms: β-estimate per additional symptom [95%-CI]: 0.48 [0.39; 0.57], p p Conclusion Each additional symptom that occurs in COVID-19 increases the likelihood of suffering a higher severity of PCF. Further research is needed to identify the aetiology of PCF. Trial registration: Nr. NCT04615026. Date of registration: November 4, 2020.

Despite the need to generate valid and reliable estimates of protection against SARS-CoV-2 infection and severe course of COVID-19 for the German population in summer 2022, there was a lack of systematically collected population-based data allowing for the assessment of the protection level in real-time.In the IMMUNEBRIDGE project, we harmonised data and biosamples for nine population-/hospital-based studies (total number of participants n=33,637) to provide estimates for protection levels against SARS-CoV-2 infection and severe COVID-19 between June and November 2022. Based on evidence synthesis, we formed a combined endpoint of protection levels based on the number of self-reported infections/vaccinations in combination with nucleocapsid/spike antibody responses (“confirmed exposures”). Four confirmed exposures represented the highest protection level, and no exposure represented the lowest.Most participants were seropositive against the spike antigen; 37% of the participants ≥79 years had less than four confirmed exposures (highest level of protection) and 5% less than three. In the subgroup of participants with comorbidities, 46-56% had less than four confirmed exposures. We found major heterogeneity across federal states, with 4%-28% of participants having less than three confirmed exposures.Using serological analyses, literature synthesis and infection dynamics during the survey period, we observed moderate to high levels of protection against severe COVID-19, whereas the protection against SARS-CoV-2 infection was low across all age groups. We found relevant protection gaps in the oldest age group and amongst individuals with comorbidities, indicating a need for additional protective measures in these groups.

The use of robotic and technical systems for early mobilization of intensive care patients: A scoping review

This scoping review gives an overview of current research activities in the field of very early mobilization with robotic devices of intensive care patients. It presents the effect of very early, robot-assisted mobilization on intensive care patients based on their outcomes.

This scoping review gives an overview of current research activities in the field of very early mobilization with robotic devices of intensive care patients. It presents the effect of very early, robot-assisted mobilization on intensive care patients based on their outcomes.