ICU sedation, delirium & recovery
Improving Recovery and Outcomes Every Day After the ICU (IMPROVE): A Randomized Controlled Trial
Authors' conclusion
The Improving Recovery and Outcomes Every Day After the ICU (IMPROVE) trial did not result in improved cognitive, physical, mental health, or quality of life measures at 3 or 6 months.
Study context
- Population
- ICU adults ≥50 years with at least one instance of ICU delirium or subsyndromal delirium; 4 sites (academic, county, community ICUs)randomized
- Participants
- One hundred fifty-three adults
- Comparison
- Web-based combined cognitive and physical training (12 weeks): Physical exercise-cognitive training (PE-CT), physical exercise-cognitive control (PE-CC), stretching control-cognitive training (SC-CT) vs stretching control-cognitive control (SC-CC)
- PE-CTn = 41
- PE-CCn = 41
- SC-CTn = 36
- SC-CCn = 35reference
- Primary endpoint
- Cognitive function (RBANS)
- Follow-up
- 3 and 6 months after start of intervention
Methodological detailsprospective, four-arm, multicentre
- Prospective
- Four-arm
- Multicentre
Primary result
As reported in the abstract
Change in RBANS z score · 3 and 6 months
Each group vs SC-CCMean estimated difference in change from baseline (95% CI)P value
SC-CT3 months; worsening
−0.28(−0.53 to −0.02)
P = 0.035SC-CT6 months; worsening
−0.29(−0.53 to −0.04)
P = 0.021PE-CC6 months; worsening
−0.26(−0.49 to −0.02)
P = 0.035- Significant difference in changes in Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) z scores among the four arms
- interaction term p = 0.012
Further findings
Physical or mental quality of life, depression, anxiety · all timepoints
- No significant differences between groups
Original publication
Improving Recovery and Outcomes Every Day After the ICU (IMPROVE): A Randomized Controlled Trial. Crit Care Med. Published 22 May 2025. doi:10.
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