Standardized Rehabilitation for Intensive Care Unit (ICU) Patients With Acute Respiratory Failure
Acute Respiratory Failure (ARF) requiring mechanical ventilation affects 1.1 million of the 4.4 million people admitted to United States Intensive Care Units (ICU) every year. Patients with ARF have an average ICU and hospital length of stay (LOS) of 8 and 15 days, respectively, with median hospital costs greater than $30,000 United States. Patients with ARF experience deconditioning, muscle weakness, joint contractures, dyspnea, depression, and reduced health-related quality of life, all of which may contribute to prolonged hospitalization and increased costs. Mechanistically, it is understood that patients with ARF demonstrate acute inflammation which may contribute to the above cited problems. While the investigators' research and that of others has shown that rehabilitation therapy can increase functional outcomes while lowering biomarkers of inflammation in the frail aged and other clinical populations, it is not known whether such rehabilitation therapy can result in improved functional capacity and functional performance and reduce inflammation in ARF patients. There is previous evidence for the feasibility and safety of rehabilitation therapy in ARF patients. Therefore, the investigators propose a two-arm, randomized trial in 326 patients with ARF to compare Standardized Rehabilitation Therapy initiated in the ICU and administered throughout the hospitalization versus usual care (control). Standardized Rehabilitation Therapy will consist of: passive range of motion, physical therapy and progressive resistance exercise (strength training). The regimen will be administered 7 days/week by a Mobility Team consisting of a critical care nurse, physical therapist and nursing assistant.
The investigators will determine whether standardized rehabilitation therapy will reduce hospital LOS, improve functional capacity and performance, improve quality of life, reduce inflammation and reduce hospital costs as compared to usual care.
This study's primary objective is to determine whether standardized rehabilitation therapy will decrease hospital length of stay.
Hypothesis: Compared to usual care, standardized rehabilitation therapy will reduce hospital length of stay for patients with Acute Respiratory Failure.
|Acute Respiratory Failure||Other: Standardized Rehabilitation Other: Usual Care|
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||Standardized Rehabilitation for ICU Patients With Acute Respiratory Failure|
- To determine whether standardized rehabilitation therapy will decrease hospital length of stay. [ Time Frame: 5 years ]
|Study Start Date:||October 2009|
|Study Completion Date:||June 2015|
|Primary Completion Date:||October 2014 (Final data collection date for primary outcome measure)|
Active Comparator: Usual Care
Other: Usual Care
Usual Physical Therapy care
Intervention arm to receive Standardized Rehabilitation Therapy
Other: Standardized Rehabilitation
3 component Rehabilitation approach, Passive Range of Motion, Physical Therapy and Progressive Resistance Training
Please refer to this study by its ClinicalTrials.gov identifier: NCT00976833
|United States, North Carolina|
|Wake Forest University Health Sciences|
|Winston Salem, North Carolina, United States, 27157|
|Principal Investigator:||Peter E. Morris, MD||Wake Forest University Health Sciences|