Ventilation & weaning · Rehabilitation in the critically ill
Standardized Rehabilitation and Hospital Length of Stay Among Patients With Acute Respiratory Failure
| Design | Randomised clinical trial |
|---|---|
| Treatment | Standardised rehabilitation therapy |
| Control | Usual care |
| Population | 300 patients with acute respiratory failure |
| Follow-up | 6 months |
| Primary endpoint | Hospital length of stay |
| Result | Median hospital length of stay 10 days (IQR 6 to 17) with standardised rehabilitation and 10 days (IQR 7 to 16) with usual care — median difference 0 days (95% CI -1.5 to 3, p=0.41). No difference in duration of ventilation or ICU care, and no effect at 6 months on handgrip strength. |
| Secondary endpoints | Duration of ventilation, ICU length of stay, handgrip and handheld dynamometry at 6 months |
Among patients hospitalized with acute respiratory failure, SRT compared with usual care did not decrease hospital LOS.
The trial authors, in the published abstract
The third concordant negative rehabilitation trial alongside Moss 2016 and TEAM. Early mobilisation remains sensible practice; what these trials rule out is that adding more of it to usual care changes outcomes.
Morris PE, Berry MJ, Files DC, et al. Standardized Rehabilitation and Hospital Length of Stay Among Patients With Acute Respiratory Failure: A Randomized Clinical Trial. JAMA 2016 Jun 28;315(24):2694-702.