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Predictors of Prognosis in Patients With Critical Illness.

13. Juli 2021 aktualisiert von: Taoyuan General Hospital

Recently, intensive care unit acquired weakness (ICUAW) has become a hotspot issue in the patients with critical illness. The symptoms of ICUAW, including sensory impairment and muscle atrophy, may lead to poor quality of life even though the patients discharged from the ICU for a long time. Therefore, an ounce of prevention is worth a pound of cure. At the same time, early evaluation is necessary to keep critically ill patients away from ICUAW. Medical Research Council (MRC) scale is the most common approach for diagnosis clinically. Regarding the interrater variation of MRC, handgrip strength (HGS) has been thought to be a simple and accurate alternative. However, HGS does not belong to antigravity or respiratory muscle which are the first to be affected by immobilization. It is still unknown whether HGS can represent the general muscle condition in ICU or not.

Additionally, previous studies have proved that patients with critical illness in the ICU would have better prognosis and less complications, if they undergo physical therapy as soon as possible. In addition to early ventilator weaning and reduced mortality rate, physical therapy could enhance quality of life (QoL) after patient discharges from hospital. However, early mobility in the ICU mainly emphasizes cardiopulmonary patients due to the traditional concept in Taiwan. Hence, the duration of mechanical ventilation in the critical patients will affect the timing to receive physical therapy, even impact the improvement of QoL.

Because of these reasons, this study will investigate the relationship between HGS and muscle mass among patients with critical illness and find the predictors of the short-term and long-term goals in the ICU, including ventilator weaning and QoL after hospital discharge.

Studienübersicht

Detaillierte Beschreibung

This prospective and observational study will be divided into 2 parts: 1) The association between handgrip strength and muscle mass in intensive care unit patients. 2) Predictors of short-term and long-term goals in ICU.

Patients in the surgery intensive care unit of Taoyuan General Hospital will be recruited and evaluated in 48 hours from admission to ICU. The outcome measures include HGS assessed by electronic hand dynamometer and muscle thickness of diaphragm and quadriceps detected by ultrasound.

The short-term goal is weaning ventilator, and the long-term goal is quality of life after discharge from hospital assessed through SF-36 Taiwan version. Patients in the surgery intensive care unit of Taoyuan General Hospital will be recruited and evaluated in 48 hours after ICU admission. The collected data contain muscle strength, muscle mass, physical function, respiratory function, and observation of delirium or not. The evaluations of muscle strength include 3 parts which are limbs(handgrip), respiratory muscle(Maximal Inspiratory Pressure), and general muscle strength(Medical Research Council scale); Secondly, the evaluations of muscle mass divide 2 parts which are limbs(muscle thickness of quadriceps) and respiratory muscle(muscle thickness of diaphragm); Thirdly, the evaluations of physical function are 2 ways which are FSS-ICU and 2 mins walk test after discharge from the ICU; Fourthly, the evaluations of respiratory function contain 3 measurements of FEV1, FVC, and FEV1/FVC; Finally, the evaluation of delirium is assessed by CAM-ICU.

The statistical analysis will use SPSS version 24. Pearson correlation test will be conducted to investigate the association between HGS and muscle thickness. Multiple regression will be used to investigate the predictors for weaning ventilator successfully and quality of life after hospital discharge.

Studientyp

Beobachtungs

Einschreibung (Tatsächlich)

400

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienorte

      • Taoyuan, Taiwan, 330
        • Department of Rehabilitation, Taoyuan General Hospital, Ministry of Health and Welfare, Taiwan

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

  • Kind
  • Erwachsene
  • Älterer Erwachsener

Akzeptiert gesunde Freiwillige

Nein

Studienberechtigte Geschlechter

Alle

Probenahmeverfahren

Nicht-Wahrscheinlichkeitsprobe

Studienpopulation

Patients in the surgery intensive care unit will be recruited and evaluated in 48 hours from admission to ICU

Beschreibung

Inclusion Criteria:

  • Patients in the surgery intensive care unit will be recruited and evaluated in 48 hours from admission to ICU

Exclusion Criteria:

  • Hemodynamic instability patients, e.g., patients with ECMO
  • Patients refuse to participate this study

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Part 1: Change of handgrip strength (HGS) from ICU admission to ICU discharge
Zeitfenster: every day during the ICU stay until patients discharge from ICU assessed up to 14 days
Handgrip strength (HGS) assessed by electronic hand dynamometer(Electronic hand dynamometer, CAMRY, MODEL, EH101)
every day during the ICU stay until patients discharge from ICU assessed up to 14 days
Part 1: Change of diaphragm thickness from ICU admission to ICU discharge
Zeitfenster: every day during the ICU stay until patients discharge from ICU assessed up to 14 days
Muscle thickness of diaphragm and quadriceps detected by ultrasound(GE vivid S5)
every day during the ICU stay until patients discharge from ICU assessed up to 14 days
Part 2: Change of Handgrip strength (HGS)
Zeitfenster: Baseline: admission to ICU in 48 hours. Progress: the day that patients received weaning profile test
Change of Handgrip strength (HGS) assessed by electronic hand dynamometer(Electronic hand dynamometer, CAMRY, MODEL, EH101)
Baseline: admission to ICU in 48 hours. Progress: the day that patients received weaning profile test
Part 2: Change of General muscle strength
Zeitfenster: Baseline: admission to ICU in 48 hours. Progress: the day that patients received weaning profile test
Change of General muscle strength- MRC scale
Baseline: admission to ICU in 48 hours. Progress: the day that patients received weaning profile test
Part 2: Change of Muscle mass
Zeitfenster: Baseline: admission to ICU in 48 hours. Progress: the day that patients received weaning profile test
Muscle thickness of diaphragm and quadriceps detected by ultrasound (GE vivid S5)
Baseline: admission to ICU in 48 hours. Progress: the day that patients received weaning profile test
Part 2: Respiratory muscle strength
Zeitfenster: the day that patient received weaning profile tests during ICU
Respiratory muscle strength- Maximal Inspiratory Pressure(MIP)
the day that patient received weaning profile tests during ICU
Part 2: Change of Physical function
Zeitfenster: Baseline: admission to ICU in 48 hours. Progress: the day that patients received weaning profile test
Change of FSS-ICU
Baseline: admission to ICU in 48 hours. Progress: the day that patients received weaning profile test
Part 2: Physical function at ICU discharge
Zeitfenster: conducted at the day of ICU discharge
2 mins walk test
conducted at the day of ICU discharge
Part 2: Change of Delirium
Zeitfenster: conducted every day in the ICU
CAM-ICU
conducted every day in the ICU
Part 2: Respiratory function
Zeitfenster: conducted at the day of ICU discharge
FVC, FEV1, FEV1/ FVC assessed by ezOxygen (EZO-G001)
conducted at the day of ICU discharge
Part 2: Quality of life- SF-36(Taiwan version)
Zeitfenster: conducted by phone call at discharge for 6 months from ICU
SF-36(Taiwan version)
conducted by phone call at discharge for 6 months from ICU

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Ermittler

  • Studienstuhl: Huan-Jui Yeh, Department of Rehabilitation, Taoyuan General Hospital, Ministry of Health and Welfare

Publikationen und hilfreiche Links

Die Bereitstellung dieser Publikationen erfolgt freiwillig durch die für die Eingabe von Informationen über die Studie verantwortliche Person. Diese können sich auf alles beziehen, was mit dem Studium zu tun hat.

Allgemeine Veröffentlichungen

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

1. Januar 2020

Primärer Abschluss (Tatsächlich)

13. Juli 2021

Studienabschluss (Tatsächlich)

13. Juli 2021

Studienanmeldedaten

Zuerst eingereicht

25. Mai 2021

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

30. Mai 2021

Zuerst gepostet (Tatsächlich)

4. Juni 2021

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

19. Juli 2021

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

13. Juli 2021

Zuletzt verifiziert

1. Juli 2021

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

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