Standardized Rehabilitation and Hospital Length of Stay Among Patients With Acute Respiratory Failure: A Randomized Clinical Trial

Physical rehabilitation in the intensive care unit (ICU) may improve the outcomes of patients with acute respiratory failure.  This US single centre randomised controlled trial compared standardized rehabilitation therapy (SRT) to usual ICU care in acute respiratory failure.  It was published in JAMA on the 28th June 2016.

Adult patients (mean age, 58 years; women, 55%) admitted to the ICU with acute respiratory failure requiring mechanical ventilation were randomized to 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 primary outcome was hospital length of stay (LOS) with secondary outcomes including ventilator days, ICU days and Short Physical Performance Battery (SPPB) score.  Among 300 randomized patients, the median hospital LOS was 10 days (IQR, 6 to 17) for the SRT group and 10 days (IQR, 7 to 16) for the usual care group (median difference, 0 [95% CI, -1.5 to 3], P = .41).  For the secondary indicators the SRT group showed a statistically significant improvement in some but not in others.

The trial concluded that amongst patients hospitalized with acute respiratory failure, SRT compared with usual care did not decrease hospital length of stay.

This journal is available to read in the healthcare library on Level D of the hospital or the full text can be accessed via this link which does not require a password.

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