Improving rehabilitation after critical illness

Published Date: 19th July 2016

Publication Authors: Jones C, McCairn AJ

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Purpose

Patients recovering from critical illness may be left with significant muscle mass loss. This study aimed to evaluate whether a 6-week program of enhanced physiotherapy and structured exercise (PEPSE) and an essential amino acid supplement drink (glutamine and essential amino acid mixture [GEAA]) improves physical and psychological recovery.

Materials and methods

Intensive care patients aged 45 years or older, with a combined intensive care unit stay/pre–intensive care unit stay of 5 days or more were recruited to a randomized controlled trial examining the effect of PEPSE and GEAA on recovery. The 2 factors were tested in a 2 × 2 factorial design: (1) GEAA drink twice daily for 3 months and (2) 6-week PEPSE in first 3 months. Primary efficacy outcome was an improvement in the 6-minute walking test at 3 months.

Results

A total of 93 patients were randomized to the study. Patients receiving the PEPSE and GEA had the biggest gains in distance walked in 6-minute walking test (P < .0001). There were also significant reductions in rates of anxiety in study groups control supplement/PEPSE (P = .047) and GEAA supplement/PEPSE (P = .036) and for GEAA supplement/PEPSE in depression (P = .0009).

Conclusion

Enhanced rehabilitation combined with GEAA supplement may enhance physical recovery and reduce anxiety and depression.

Jones, C; Eddleston, J; McCairn, A; Dowling, S; McWilliams, D; Coughlan, E; Griffiths, RD. (2015). Improving rehabilitation after critical illness through outpatient physiotherapy classes and essential amino acid supplement: A randomized controlled trial​ . Journal of Critical Care. 30 (5), 901-907

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