ICU sedation, delirium & recovery
Effect of early mobilisation on long-term cognitive impairment in critical illness in the USA: a randomised controlled trial
Primary resultResult — go to the resultAbsolute difference −19.2% 95% CI −32.1 to −6.3%Authors' conclusion
Early mobilisation might be the first known intervention to improve long-term cognitive impairment in ICU survivors after mechanical ventilation.
Study context
- Population
- Functionally independent adults mechanically ventilated within the first 96 h, expected to continue ≥24 h, medical-surgical intensive-care unit (ICU), University of Chicago, USA99 per group in ITT analysis
- Participants
- 200 participants
- Comparison
- Early mobilisation vs usual care
- Early mobilisationn = 100
- Usual caren = 100reference
- Primary endpoint
- Cognitive impairment (Montreal Cognitive Assessment)
- Follow-up
- 1 year after hospital discharge
Methodological detailssingle-centre, parallel, assessor-masked
- Single-centre
- Parallel
- Assessor-masked
Primary result
As reported in the abstract
1 year
Absolute difference
−19.2%
95% CI −32.1 to −6.3%
P = 0.0043
Events by treatment group
Early mobilisation vs Usual care
absolute difference −19.2% (95% CI −32.1 to −6.3%); P = 0.0043
Further findings
| Outcome | Early mobilisation | Usual care | Absolute difference (CI) | P value | |
|---|---|---|---|---|---|
| ICU-acquired weakness · 1 year | 0% | 14% | −14.1% (−21.0 to −7.3) | P = 0.0001 | |
| Functional independence · 1 year | 65% | 62% | 3% (−10.4 to 16.5%) | P = 0.66 | |
| −30−20−1001020Difference (linear scale) |
Median
| Outcome | Early mobilisation | Usual care | P value |
|---|---|---|---|
| Quality of life, physical component score · 1 year | 52.4 (IQR 45.3–56.8) | 41.1 (IQR 31.8–49.4) | P < 0.0001 |
| Quality of life, mental component score · 1 yearNo difference | 55.9 (IQR 50.2–58.9) | 55.2 (IQR 49.5–59.7) | P = 0.98 |
Safety
| Outcome | Early mobilisation | Usual care | P value |
|---|---|---|---|
| Adverse events (haemodynamic changes 3, arterial catheter removal 1, rectal tube dislodgement 1, respiratory distress 2) | 6% | 0 events | P = 0.029 |
- Adverse events (haemodynamic changes 3, arterial catheter removal 1, rectal tube dislodgement 1, respiratory distress 2) — Total adverse events in Early mobilisation
- 7
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Effect of early mobilisation on long-term cognitive impairment in critical illness in the USA: a randomised controlled trial. Lancet Respir Med. Published 21 January 2023. doi:10.
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