ICU-acquired Weakness
Conditions
Keywords
early rehabilitation, early mobilization, surgical intensive care unit
Brief summary
The purpose of this study is to determine whether an early rehabilitation program in surgical intensive care unit is safe and effective in preventing critical care illness and intensive care unit acquired weakness.
Detailed description
Due to the complications like intensive care unit-acquired weakness, critical illness polyneuropathy and neuropsychiatric disease of critical care, many organizations focus on rehabilitation in critically ill patients' management. Despite the good outcomes from papers, there are debatable issues of method, safety and efficacy of rehabilitation. The investigators developed an early rehabilitation program (ERP) in our surgical ICU management and assessed safety and efficacy of it. The ERP started in November 2014 in our 14-bed surgical ICU in Asan Medical Center. The investigators focused on early and 5-step rehabilitation program for patients who were admitted to SICU for at least 3 days. The investigators enrolled 69 patients (pre-ERP group) for 6 months before November 2014 and 62 patients (post-ERP group) for 6 months 1 year after the ERP started. The main measures were safety issues, delirium days, 28-d ventilator free-days, 28-d ICU free-days, hospital length of stay (LOS), ICU mortality, in-hospital mortality and 1 year mortality.
Interventions
BEHAVIORALEarly rehabilitation program
The investigators evaluated patients who were admitted SICU for more than 3 days for an early rehabilitation program and delivered one of 5-stepped rehabilitation program if the patient was eligible.
Sponsors
Asan Medical Center
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* patients who were admitted in SICU for at least 3 days
Exclusion criteria
* readmission to SICU within current hospitalization open abdomen wound patients major bone fracture patients brain death patients active bleeding patients increased intra-cranial pressure patients paraplegic patients patients or their guardians did not agree with the ERP doctor's decision (Deconditioning patients, Procedure)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 28-day Ventilator-free days (days) | up to 28-day | Patients who died during the study were assigned scores of 0 for 28-day ventilator-free days. |
| 28-day ICU-free days (days) | up to 28-day | Patients who died during the study were assigned scores of 0 for 28-day ICU-free days |
Secondary
| Measure | Time frame |
|---|---|
| Total rehabilitation days within ICU days (days) | up to 4 weeks |
| ICU readmission rate (%) | up to 24 weeks |
| Time to start rehabilitation from ICU admission (days) | up to 2 weeks |
| in-hospital mortality rate (%) | up to 24 weeks |
| 1 year mortality rate (%) | 1 year follow up from ICU admission |
| ICU mortality rate (%) | up to 24 weeks |
| ICU delirium days (days) | up to 4 weeks |
Outcome results
None listed