A comparison of earlier and enhanced rehabilitation of mechanically ventilated patients in critical care compared to standard care (REHAB): study protocol for a single-site randomised controlled feasibility trial

Pilot and Feasibility Studies

Tonny Veenith¹  Catherine Snelson¹  Tony Whitehouse¹  James Hodson²  David Thickett³  Lauren Cooper⁴  Emma Reeves⁴  Aisling McLaughlin⁴  Gemma Atkins⁵  David McWilliams⁵  Charlotte Jones⁵ 

[1] Department of Critical Care, University Hospitals Birmingham NHS Foundation Trust;Department of Statistics, University Hospitals Birmingham NHS Foundation Trust;Institute of Inflammation and Ageing, College of Medical and Dental Sciences, Centre for Translational Inflammation Research, University of Birmingham Laboratories, Queen Elizabeth Hospital Birmingham;National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital Birmingham;Therapy Services, University Hospitals Birmingham NHS Foundation Trust;

关键词: Critical care;    Mechanical ventilation;    Rehabilitation;    Physiotherapy;   

DOI  :  10.1186/s40814-017-0131-1

来源: DOAJ

【 摘 要 】

Abstract Background Mortality from critical illness is improving, but survivors suffer from prolonged weakness and psychological and cognitive impairments. Maximising the recovery after critical illness has been highlighted as a research priority, especially in relation to an ageing population who present with higher rates of pre-morbid disability. Small studies have shown that starting rehabilitation early within the intensive care unit (ICU) improves short-term outcomes. Systematic reviews have highlighted the need for robust multicentre randomised controlled trials with longer term follow-up. Methods The study design is a randomised controlled study to explore the feasibility of providing earlier and enhanced rehabilitation to mechanically ventilated patients at high risk of ICU-acquired weakness within the ICU. The rehabilitation intervention involves a structured programme, with progression along a functionally based mobility protocol according to set safety criteria. The overall aim of the intervention is to commence mobilisation at an earlier time point in the patient’s illness and increase mobility of the patient through their recovery trajectory. Participants will be randomised to enhanced rehabilitation or standard care, with the aim of recruiting at least 100 patients over 16 months. The trial design will assess recruitment and consent rates from eligible patients, compliance with the intervention, and assess a range of possible outcome measures for use in a definitive trial, with follow-up continuing for 12 months post hospital discharge. Discussion This study will evaluate the feasibility of providing an earlier and enhanced rehabilitation intervention to mechanically ventilated patients in critical care. We will identify strengths and weaknesses of the proposed protocol and the utility and characteristics of the outcome measures. The results from this study will inform the design of a phase III multicentre trial of enhanced rehabilitation for critically ill adults. Trial registration ISRCTN90103222 , 13/08/2015; retrospectively registered.

【 授权许可】

Unknown