Treatment of Critical Illness Polyneuromyopathy (Do It Now)
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Purpose
Acute respiratory failure is a heterogeneous disorder that results in more than 300,000 Americans requiring admission to an intensive care unit for invasive mechanical ventilatory support each year. Though acute respiratory failure is a pulmonary disorder, patients who survive their hospitalization are not limited by respiratory symptoms after discharge. Rather persistent neuromuscular weakness is the primary disorder that adversely alters their quality of life and ability to function on a daily basis. In this application we plan to conduct a randomized clinical trial called the Do It Now study (Diagnosis and Treatment of Neuromuscular Weakness) to determine the effectiveness of an intensive physical therapy program for patients recovering from acute respiratory failure. This trial will establish the efficacy of the physical therapy programs that is currently performed for patients with acute respiratory failure in a non-evidence based manner across the United States.
| Condition | Intervention | Phase |
|---|---|---|
|
Acute Respiratory Failure |
Procedure: intensive physical therapy Procedure: control group |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Randomized Trial of Intensive Physical Therapy for Patients With Acute Respiratory Failure |
- The primary outcome variable for this study will be the short form of the Continuous Scale Physical Functional Performance Test (CS-PFP) called the PFP-10 [ Time Frame: 1, 3, and 6 months ] [ Designated as safety issue: No ]
- Two minute walk test (2 MWT), Timed Up and Go Test (TUG), and Health Related Quality of Life Measurements:Medical Outcomes Study 36-Item Short Form Health Survey, Standard Form (SF-36). [ Time Frame: 1, 3, and 6 months ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 120 |
| Study Start Date: | September 2009 |
| Estimated Study Completion Date: | January 2014 |
| Estimated Primary Completion Date: | January 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Intensive physical therapy
four week intervention of daily intensive physical therapy
|
Procedure: intensive physical therapy
four week course of daily intensive physical therapy
|
| Active Comparator: control arm |
Procedure: control group
four weeks of routine physical therapy
|
Detailed Description:
Acute respiratory failure is a heterogeneous disorder that results in more than 300,000 Americans requiring admission to an intensive care unit for invasive mechanical ventilatory support each year. Though acute respiratory failure is a pulmonary disorder, patients who survive are not limited by respiratory symptoms after discharge. Rather persistent neuromuscular weakness is the primary disorder that adversely affects their quality of life and ability to function on a daily basis. Weakness in these survivors is related to the development of critical illness polyneuromyopathy (CIPNM). Presently, there are no therapies to treat the estimated 110,000 acute respiratory failure survivors who have developed CIPNM each year. Based on the results of our national surveys of physical therapists and intensive care physicians, the utilization and types of physical therapy for patients recovering from acute respiratory failure with neuromuscular weakness varies significantly depending on the type of hospital and primary diagnosis of the patient. We plan to perform a randomized clinical trial to determine the effectiveness of an intensive four week physical therapy program for patients with acute respiratory failure. This trial will determine the efficacy of the physical therapy programs that is currently performed in a non-evidence based manner for patients with acute respiratory failure across the United States. If successful, our study will pave the way for a larger multi-center clinical trial of intensive physical therapy for survivors of acute respiratory failure.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Acute respiratory failure requiring mechanical ventilation for at least four days.
Exclusion Criteria:
- Recent myocardial infarction within the last 3 weeks, presence of signs or symptoms of unstable angina or history of unstable arrhythmias including ventricular tachycardia and atrial fibrillation (HR > 100 bpm).
- Recent history of pulmonary embolism within the last six weeks.
- History of severe aortic stenosis.
- Presence of a dissecting aortic aneurysm.
- Significant language barrier that would limit the ability to participate in the physical therapy program.
- Patients who live greater than 45 miles from the University of Colorado Hospital.
- Underlying disorder that makes it unlikely that the patient will survive 6 months.
- Severe physical or cognitive impairment that would impair their ability to exercise.
Contacts and Locations| Contact: Marc Moss, M.D. | 303-724-6079 | marc.moss@ucdenver.edu |
| Contact: Meredith Mealer, R.N. | 303-724-6080 | meredith.mealer@ucdenver.edu |
| United States, Colorado | |
| University of Colorado Denver | Recruiting |
| Aurora, Colorado, United States, 80045 | |
| Contact: Marc Moss, M.D. 303-724-6079 marc.moss@ucdenver.edu | |
| Principal Investigator: Marc Moss, M.D. | |
More Information
No publications provided
| Responsible Party: | University of Colorado, Denver |
| ClinicalTrials.gov Identifier: | NCT01058421 History of Changes |
| Other Study ID Numbers: | 09-0214 |
| Study First Received: | January 26, 2010 |
| Last Updated: | November 20, 2012 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by University of Colorado, Denver:
|
mechanical ventilation acute respiratory failure physical therapy critical illness neuropathy critical illness myopathy |
Additional relevant MeSH terms:
|
Critical Illness Respiratory Distress Syndrome, Adult Respiratory Insufficiency Disease Attributes |
Pathologic Processes Lung Diseases Respiratory Tract Diseases Respiration Disorders |
ClinicalTrials.gov processed this record on May 22, 2013