Exploration of Investigating ICU Mobilisation With Vasoactive Drugs

Investigating the Safety of Mobilising Intensive Care Unit Patients Receiving Vasoactive Drugs: An Exploratory Observational Study

There is a need to know more about the safety of mobilizing intensive care unit (ICU) patients who are receiving vasoactive drugs that support the heart and blood pressure. But before this research can be done, several uncertainties need to be addressed.

To answer these uncertainties, the investigators will ask ICU patients receiving vasoactive drugs to take part in a study in three main stages. Firstly ICU patients will be asked whether they would be happy to take part in a future research trial on the safety of mobilizing patients who are receiving vasoactive drugs. Secondly, data will be collected about the current mobilization on vasoactive drugs that occurs. Finally, the investigators will try to follow up these patients 60 days after they start the study, to carry out some questionnaires and a walking test with the patients. These tests may be used in future research to measure the effect of mobilizing patients on vasoactive drugs.

The current evidence is insufficient to accurately guide clinicians to know when it is safe to start mobilizing intensive care unit (ICU) patients receiving vasoactive drugs. Before a randomized controlled trial can be designed, several uncertainties need to be addressed. This includes clarifying what standard care is, what potential recruitment rates would be and what the most suitable primary outcome measure is.

This study is an exploratory observational study which will aim to recruit up to 40 ICU patients receiving vasoactive drugs to further clarify standard care and to measure preliminary feasibility outcomes.

Upon enrolment, patients and clinicians will be surveyed about the hypothetical acceptability of recruitment into a future randomized controlled trial. Then any routine mobilization that occurs whilst the patient is receiving vasoactive drugs will be analyzed, for example, to describe how clinicians assessed safety for mobilization. Finally, patient participants will be followed up at day 60 to assess the feasibility of measuring candidate primary outcome measures.

Patient participants:

Inclusion Criteria:

• Patients admitted to the ICU who are receiving vasoactive drugs.
• Age greater than or equal to 18 years old.
• Expected to remain admitted to the ICU for at least 24 hours post-enrolment.

Exclusion Criteria:

• Any patient who is expected to die imminently, as per clinical opinion.
• Any patient where mobilization is contraindicated by the nature of their existing injuries.
• Where it is clear from the medical records that participants are prisoners or offenders on probation.
• Patients with neuromuscular disease or acute brain injury or spinal cord injury.
• If the patient and/or their consultee is unable to speak English.

Clinicians participating in a survey on hypothetical randomization of patient participants:

Inclusion criteria:

• Clinicians who work in the intensive care unit where a patient participant has been admitted.

Exclusion criteria:

• None.

Clinician participants in the survey on the feasibility of the ICU physical rehabilitation adverse event tool:

Inclusion criteria:

• An ICU clinician at the research site.
• Has used the ICU physical rehabilitation adverse event tool as part of this research study.

Exclusion criteria:

• None.