In a study appearing in the June 28 issue of JAMA, Peter E. Morris, M.D., of the University of Kentucky, Lexington, and colleagues compared outcomes for standardized rehabilitation therapy to usual intensive care unit (ICU) care for acute respiratory failure.
Acute respiratory failure is associated with high mortality and prolonged illness, with impaired physical function for many survivors. Interventions directed at lessening the profound muscle wasting in patients with acute respiratory failure are patient-centered. Such therapies designed to improve patient-reported weakness and impaired physical function could reduce recovery time in patients. Reports have suggested that a rehabilitation program, delivered by an ICU rehabilitation team, may be associated with reduced length of stay (LOS) and improved physical function, although findings to the contrary exist as well.
In this study, 300 patients admitted to an ICU with acute respiratory failure requiring mechanical ventilation were randomly assigned to standardized rehabilitation therapy (SRT; n=150) or usual care (n=150) with 6-month follow-up. Patients in the SRT group received daily therapy until hospital discharge, consisting of passive range of motion, physical therapy, and progressive resistance exercise. The usual care group received weekday physical therapy when ordered by the clinical team.
The researchers found that the median hospital LOS was 10 days for the SRT group and 10 days for the usual care group. There was no difference in duration of ventilation or ICU care. Functional-related and health-related quality-of-life outcomes were similar for the 2 study groups at hospital discharge.