Effect Of Acute Inflammatory Mediators On Functional Limitations In Patients With Acute Respiratory Failure
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Purpose
This is a randomized, controlled, pilot study of two separate Cohorts of patients from the intensive care unit. Cohort I will enroll 50 patients and randomize to receive one physical therapy session per day or receive usual ICU care. Cohort II, will enroll an additional 50 patients and randomize to receive either two physical therapy sessions per day or usual care. Outcome will be length of hospital stay measured in days. Secondary outcomes will be mortality, ventilator days, ICU days, and for Cohort II, grip strength, dynamometer strength assessments and the short physical performance battery (SPPB). Study subjects will have blood for cytokine analysis through their first week of study.
| Condition | Intervention | Phase |
|---|---|---|
|
Acute Respiratory Failure |
Other: Early ICU rehabilitation strategies Other: Usual Care |
Phase 1 Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Effect Of Acute Inflammatory Mediators On Duration Of Functional Limitations In Patients With Acute Respiratory Failure, A Randomized, Controlled Pilot Study of Early ICU Rehabilitation Strategies |
- Hospital length of stay, days [ Time Frame: The participants will be followed for the duration of the hospitalization, an expected average of 3 weeks. ] [ Designated as safety issue: No ]Hospital stay measured in days.
| Enrollment: | 100 |
| Study Start Date: | July 2007 |
| Study Completion Date: | August 2009 |
| Primary Completion Date: | July 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Usual Care
Usual hospital rehabilitative services
|
Other: Usual Care
All typically applied hospital rehabilitative services applied in the usual fashion
Other Name: Usual Hospital Rehabilitative Services
|
|
Experimental: Early ICU Rehabilitation Strategy
Early ICU physical therapy will be applied in this arm
|
Other: Early ICU rehabilitation strategies
Physical therapy - standard; Physical therapy, progressive resistance training for 2nd physical therapy session in Cohort II
Other Name: Cohort I will receive one physical therapy session per day; Cohort II will receive 2 physical therapy sessions per day.
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
• Mechanically ventilated via an endotracheal tube or mask
Exclusion Criteria:
- Inability to walk without assistance prior to acute ICU illness (use of a cane or walkers not exclusions)
- Cognitive impairment prior to acute ICU illness (non-verbal)
- Preadmit immunocompromised (>prednisone 20 mg/d for 2 wks)
- Acute stroke
- Body mass index (BMI) >45
- Neuromuscular disease that could impair weaning (myasthenia gravis, ALS, Guillain-Barre)
- Hip fracture, unstable cervical spine or pathological fracture
- Mech vent >48 hours prior to transfer from an outside facility
- Current hospitalization or transferring hospital stay >72 hours
- CPR on admission, DNR on admission
- Hospitalization within 30 days prior to admission
- Cancer therapy within last 6 months
- Re-admission to ICU within current hospitalization
Contacts and Locations| United States, North Carolina | |
| Wake Forest School of Medicine | |
| Winston Salem, North Carolina, United States, 27157 | |
| Principal Investigator: | Peter E. Morris, MD | Wake Forest School of Medicine |
More Information
No publications provided
| Responsible Party: | Peter E. Morris, Professor, Wake Forest University |
| ClinicalTrials.gov Identifier: | NCT01707303 History of Changes |
| Other Study ID Numbers: | IRB00000240 |
| Study First Received: | October 10, 2012 |
| Last Updated: | October 12, 2012 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Wake Forest University:
|
ICU Critical Care Intensive Care Critical Illness Acute Respiratory Failure |
Mechanical Ventilation Physical Therapy Strength Functional Status Short Physical Performance Battery |
Additional relevant MeSH terms:
|
Respiratory Distress Syndrome, Adult Respiratory Insufficiency Lung Diseases Respiratory Tract Diseases Respiration Disorders |
ClinicalTrials.gov processed this record on May 16, 2013