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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
Snelson, Catherine Jones, Charlotte Atkins, Gemma Hodson, James Whitehouse, Tony Thickett, David Reeves, Emma McLaughlin, Aisling Cooper, Lauren
Snelson, Catherine
Jones, Charlotte
Atkins, Gemma
Hodson, James
Whitehouse, Tony
Thickett, David
Reeves, Emma
McLaughlin, Aisling
Cooper, Lauren
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Other contributors
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Epub Date
Issue Date
2017-12-17
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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.
Citation
Snelson, C., Jones, C., Atkins, G. et al. 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 Feasibility Stud 3, 19 (2017). https://doi.org/10.1186/s40814-017-0131-1
Publisher
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Research Unit
PubMed ID
28428892 (pubmed)
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Journal article
Language
en
Description
© 2017 The Authors. Published by SpringerNature. This is an open access article available under a Creative Commons licence.
The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.1186/s40814-017-0131-1
Series/Report no.
ISSN
2055-5784
EISSN
2055-5784
ISBN
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Sponsors
This trial has been funded by the QEHB Critical Care Research Management Group, with additional funding for the exploratory laboratory work on vitamin D and cortisol metabolites from a Medical Research Council grant held by one of the co-investigators.
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Licence for published version: Creative Commons Attribution 4.0 International