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ROBotic-assisted Early Mobilization in ventilated surgical critically ill patients (ROBEM-I)-A randomized,

Marco Lorenz¹, Nadine Langer¹, Philipp Kloss¹

¹Charité́ - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Department of Anesthesiology and Intensive Care Medicine (CVK, CCM), Berlin, Germany.

Anaesthesia, Critical Care & Pain Medicine

|May 25, 2025

Abstract

Background:

A shortage of human resources is a key barrier to the early mobilization of mechanically ventilated ICU patients. Recent advancements in robotic mobilization systems offer promising solutions to this challenge.

Objective(S):

This study assessed the operability of an AI-assisted robotic mobilization system by a single healthcare provider, along with its safety, feasibility, and potential benefits for mechanically ventilated surgical ICU patients.

Design:

Randomized controlled pilot study.

Setting:

Five surgical ICUs at Charité - Universitätsmedizin Berlin, Germany, November 2020 to September 2022.

Patients:

Twenty critically ill patients requiring >24 h of mechanical ventilation.

Intervention(S):

Twice-daily robotic-assisted mobilization sessions ≥ 20 min over five days, compared to the control group receiving standard care.

Main Outcome Measures:

Number of mobilization sessions conducted by a single person.

Results:

In the robotic-assisted group, no mobility sessions were conducted by a single person (0%) vs. 26 (96%) in the control group (p < 0.001). Significant secondary outcomes included a mobilization duration of 41 min/day [IQR 36-47] in the intervention group vs. 19 min/day [IQR 13-21] in the control group (p < 0.001) and higher mobilization frequency, with two units/day [IQR 2-2] in the intervention group vs. 0.9 units/day [IQR 0.7-1.0] in the control group (p < 0.001). Interleukin-6 levels decreased significantly by -4.65 pg/mL [IQR -13.00-3.83] in the intervention group vs. an increase of 3.70 pg/ml [IQR -1.30-28.88] in the control group (p = 0.049).

Conclusions:

Robotic-assisted mobilization in mechanically ventilated critically ill patients did not reduce required healthcare providers but increased the duration and frequency, and significantly reduced IL-6 levels compared to the standard group.

Trial Registration:

ClinicalTrials.gov, registration number NCT04423796.

Keywords:

Critical illness Critical illness polyneuropathy Early ambulation Rehabilitation Robotics

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