Congress Report 1st European Conference on Early Mobilization Peter Nydahl , Klas Karin

The first European Conference on early mobilization of nd critically ill patients took place on November, 2 and rd 3 , 2013 at the Academy for training and special training of the General Hospital in Vienna. The conference was aimed at facilitating the interdisciplinary and international exchange of knowledge about early mobilization. An international group (K. Klas, Austria; P. Nydahl, Germany; R. Gosselink, Belgium; N. Hart, England; K. Astrup & S. Hvid, Denmark; and I. Patsaki & V. Gerovasili; Greece) organized the meeting and advertised mainly via national and international networks. The two-day conference was attended by 100 nurses, physiotherapists and physicians from 16 countries: Australia, Belgium, Denmark, Germany, England, Greece, Iceland, Italy, Netherlands, Norway, Austria, Portugal, South Africa, Sweden, Switzerland and the USA. Saturday, November 2nd 2013 On the first day keynote speeches were given, which served as the foundation for the subsequent two workshops. eral methods to test the functioning capacity of ICU patients. V. Gerovasili described successful use of Neuromuscular Electrical Stimulation (NMES) in ICU patients. G. Hermann discussed other aspects of ICUacquired weakness. In a parallel workshop M. Davis posited that COPD patients are not difficult to wean. Dr. D. Martin reported on several forms of care and outcome evaluation currently used in the US. Dr. Mr Goncalves from Portugal demonstrated that even patients who were considered to not-able-to-wean could successfully be weaned from their tubes or cannula when alternative breathing and coughing aids are used. The workshops were repeated so that all participants could participate in both workshops.

Workshop The afternoon began with Prof. R. Gosselinks presentation on early rehabilitation. Using various studies, he explained that weaning and early mobilization have to be used together to ensure optimal rehabilitation for patients who have longer ICU stays. Prof. S. Nanas from Greece presented various kinds of early rehabilitation (early mobilization, ICU diaries, NMES, as well as telemedicine and manuals and training instructions after the ICU), which are currently being used in intensive care units.

Historical lecture hall We kicked off with Dr. M. Davis from England who spoke about the difficulties of weaning patients in the ICU. Based on various analyses of his work, he was able to prove that a weaning failure was not a failure of the ICU, but rather pointed to pre-existing pulmonary limitations of these respiratory patients before their ICU stays. G. Hermans, PhD from Belgium presented next on the relationship between early parenteral nutrition and ICU acquired weakness. Although early parenteral nutrition may be relevant for the metabolism of critically ill patients in order to prevent weight loss, several metaanalyses have shown that it is associated with more ICU-acquired weakness, resulting prolonged weaning and functional limitations. In the first workshop, Prof. R. Gosselink described sev-

Workshop: V. Gerovasili & R. Gosselink

In the following workshops Prof. S. Nanas and I. Patsakis described the effects of NMES. M. van der Schaaf reported on the establishment of follow-up models in the Netherlands. B. Conolly from England discussed tools with which the rehabilitation needs of ICU patients can be determined.

poldt from Vienna reported on a case series of ECMO patients with femoral cannulae being mobilized from the bed to a standing position. A. Raab from Vienna showed another ventilated patient who received therapy in a hospital swimming pool. In the second session P. Nydahl presented the results of the Mobilization-Day 2011 and called on the participants to repeat the survey in similar form in own countries. Frits van Beers, Mark Verhagen and Pieter Vaes from the Netherlands reported on the effects of elevato o ing patients to 30 and 45 on their oxygen saturation and perfusion/ventilation ratios. B. Connolly from England presented the results of her study on the accuracy of a method for determining the physical strength of ICU patients. A. Leditschke from Australia explained how patients requiring prolonged rehabilitation can be identified early. In the third session, I. Patsakis from Greece and J. Segers from Belgium reported on other ongoing studies using NMES. The physiotherapist M. Moller from Denmark explained the advantage of a bed cycling based on statistics from her own ICU.

Short discussion (D. Martin & K. Klas) After the workshops, S. Juchems summarized the workshops and facilitated a discussion on the following topics from the lectures and workshops: how can families be better integrated into the early rehabilitation? Can early mobilization also be done in delirious patients? Is early mobilization actually limited to the daytime? How can the need for mobilization skills be taught and how can an interdisciplinary approach to early rehabilitation be implemented? On Saturday evening the conference participants gathered at the nearby restaurant, "Stiegl ambulance" where Discussions were deepened and new friendships built while the piano played in the backdrop.

Helping hands in the background Feedback after the conference: "Back in Holland today after a very good weekendcongress and one and half day Wenen-town. I enjoyed it very much On behalf of my colleagues from the Academical Medical Center, University of Amsterdam, I'd like to thank you for the excellent organization of the congress in Vienna. Thanks to your initiative, a unique mixture of professions and experiences were shared during the lectures and workshops. We also had a great time, meeting many peers from different European countries during the dinner. I would like to thank you for a well structured conference! It was interesting subjects, good discussions and nice to meet and have a chat with the members of conference! I just wanted to say thank you for inviting me to be a part of the European early mobilization conference and congratulations on organising such a

One table - four nations Sunday, November 3rd 2013 focused on current projects and new approaches. C. Castelijn from the Netherlands presented an algorithm for early mobilization, which is already used by 10 other ICUs in the Netherlands. B. Clerckx and R. Gosselink from the Netherlands presented another algorithm. C. Hein and J. Lip-

wonderful event. The talks were both interesting and thought provoking Thank you for a very well organized conference! Nice dinner at saturday evening and also good with a location nearby, good directions I look back at a fantastic weekend visiting your conference in Vienna. During the two days you arranged a broad program of the current development in Europe and abroad about the implementation of early mobilization of critically ill patients. The speakers you arranged are truly opinion leaders in this matter! Together with the warm welcome we received in Vienna we are looking forward to seeing you all back at the next conference in Athens 2014 This conference added really high value to the work in the ICU. New ideas are brought forward and new networks were established. Thanks for your effort in the organization and execution of the conference Congratulations on the conference I found it very interesting and enjoyed it a lot Thank you for an excellent weekend meeting. The content was great and so well organized. Not working in the ICU but just consulting there from the rehab point of view, I have a lot to learn.

Next years European Conference on Early Mobilization th will take place in Athens, Greece on November 7 and th 8 , 2014. For information, registration and abstract submission please email to: icurehab.athens2014@gmail.com See you in Athens!