STANDARDIZED REHABILITATION THERAPY FOR ICU PATIENTS WITH ACUTE (TARGET)

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 每年住进美国重症监护病房(ICU)的440万人中，有110万人患有需要机械通气的急性呼吸衰竭(ARF)。患有ARF的患者会经历条件障碍、肌肉无力、关节痉挛、呼吸困难、抑郁和与健康相关的生活质量下降，所有这些都可能导致住院时间延长和费用增加。重症监护康复治疗对急性肾功能衰竭患者的治疗内容并不统一。这项拟议的研究将检验以下标准治疗假设：1)缩短ARF患者的住院时间；2)将改善登记后6个月的客观功能测量和生活质量；3)将减少炎症的生物标志物；4)将降低医院成本。我们将在326名ARF患者中进行一项双臂随机试验，以比较标准化康复治疗。标准化康复治疗将包括：被动活动范围、物理治疗和渐进式阻力运动。我们独特的环境提供了一支由医院出资、经验丰富的移动团队(每周7天)，由重症监护护士、物理治疗师和护理助理组成，以执行该方案。拟议的研究是我们先前工作的自然延伸。多学科方法(运动生理学、物理疗法、护理学、医学、基础科学、卫生经济学)得到初步研究的支持，并对最近的社会共识声明作出回应。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Acute Respiratory Failure (ARF) requiring mechanical ventilation affects 1.1 million of the 4.4 million people admitted to US Intensive Care Units (ICU) every year. Patients with ARF experience deconditioning, muscle weakness, joint contractures, dyspnea, depression, and reduced health-related quality of life, all of which may contribute to prolonged hospitalization and increased costs. Critical care rehabilitative therapy for patients with ARF is not uniform in its content. The proposed study will test the following standard therapy hypotheses: 1) shorten hospital stay in patients with ARF; 2) will improve objective functional measures and quality of life at 6 months post-enrollment; 3) will reduce biomarkers of inflammation; 4) will decrease hospital costs. We will conduct a two-arm, randomized trial in 326 patients with ARF to compare Standardized Rehabilitation Therapy. Standardized Rehabilitation Therapy will consist of: passive range of motion, physical therapy and progressive resistance exercise. Our unique environment provides a hospital-funded, experienced Mobility Team (7days/week) consisting of a critical care nurse, physical therapist and nursing assistant to administer this protocol. The proposed study is a natural extension of our prior work. Multidisciplinary approach(Exercise Physiology, Physical Therapy, Nursing, Medicine, Basic Science, Health Economics)is supported by preliminary studies and is responsive to recent society consensus statements.