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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| pre-ERP | No Intervention | A group of the surgical ICU patients who had standard care before Asan medical center developed an early rehabilitation program (ERP) | |
| post-ERP | Experimental | A group of the surgical ICU patients who had an early rehabilitation program (ERP) within SICU care |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Early rehabilitation program | Behavioral | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| 28-day Ventilator-free days (days) | Patients who died during the study were assigned scores of 0 for 28-day ventilator-free days. | up to 28-day |
| 28-day ICU-free days (days) | Patients who died during the study were assigned scores of 0 for 28-day ICU-free days | up to 28-day |
| Measure | Description | Time Frame |
|---|---|---|
| Time to start rehabilitation from ICU admission (days) | up to 2 weeks | |
| ICU delirium days (days) | up to 4 weeks | |
| Total rehabilitation days within ICU days (days) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Suk-kyung Hong, Ph.D. | Asan Medical Center | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 17133183 | Result | Bailey P, Thomsen GE, Spuhler VJ, Blair R, Jewkes J, Bezdjian L, Veale K, Rodriquez L, Hopkins RO. Early activity is feasible and safe in respiratory failure patients. Crit Care Med. 2007 Jan;35(1):139-45. doi: 10.1097/01.CCM.0000251130.69568.87. | |
| 25316527 | Result | McWilliams D, Weblin J, Atkins G, Bion J, Williams J, Elliott C, Whitehouse T, Snelson C. Enhancing rehabilitation of mechanically ventilated patients in the intensive care unit: a quality improvement project. J Crit Care. 2015 Feb;30(1):13-8. doi: 10.1016/j.jcrc.2014.09.018. Epub 2014 Oct 2. |
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| up to 4 weeks |
| ICU readmission rate (%) | up to 24 weeks |
| ICU mortality rate (%) | up to 24 weeks |
| in-hospital mortality rate (%) | up to 24 weeks |
| 1 year mortality rate (%) | 1 year follow up from ICU admission |
| 18596631 | Result | Morris PE, Goad A, Thompson C, Taylor K, Harry B, Passmore L, Ross A, Anderson L, Baker S, Sanchez M, Penley L, Howard A, Dixon L, Leach S, Small R, Hite RD, Haponik E. Early intensive care unit mobility therapy in the treatment of acute respiratory failure. Crit Care Med. 2008 Aug;36(8):2238-43. doi: 10.1097/CCM.0b013e318180b90e. |
| 19446324 | Result | Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, Spears L, Miller M, Franczyk M, Deprizio D, Schmidt GA, Bowman A, Barr R, McCallister KE, Hall JB, Kress JP. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009 May 30;373(9678):1874-82. doi: 10.1016/S0140-6736(09)60658-9. Epub 2009 May 14. |