Rehabilitation therapy for acute respiratory failure does not reduce hospitalization stay

by Bruce Sylvester: There is no decrease in hospital length of stay among patients hospitalized with acute respiratory failure who have received standardized rehabilitation therapy rather than usual care in the intensive care unit. Researchers reported this finding on June 28, 2016 in JAMA/Journal of the American Medical Association.

As background, investigator Peter E. Morris, M.D., professor of internal medicine at the University of Kentucky, Lexington, and colleagues noted that physical rehabilitation in the intensive care unit may improve outcomes among patients with acute respiratory failure. They designed their study to compare standardized rehabilitation therapy to usual intensive care unit  therapy, in order to identify any significant differences in outcomes.

The primary outcome of the study was hospital length of stay.

They enrolled 300 adult subjects (mean age, 58 years; women, 55%) who had been admitted to an intensive care unit with acute respiratory failure and who required mechanical ventilation. The subjects were randomized to standardized rehabilitation therapy (n=150) or usual care (n=150.

Subjects in the standardized rehabilitation therapy group underwent daily therapy until hospital discharge. The therapy included passive range of motion, physical therapy, and progressive resistance exercise. The usual care group underwent weekly physical therapy, as ordered by the clinical team.

The investigators reported a median hospital length of stay of 10 days for the standardized rehabilitation therapy group and 10 days for the usual care group.

They also reported that there was no significant difference in duration of ventilation or intensive care unit utilization between the groups. Likewise, functional-related and health-related quality-of-life outcomes were similar at hospital discharge for both groups.

“Among patients hospitalized with acute respiratory failure, SRT [standardized rehabilitation therapy] compared with usual care did not decrease hospital LOS [length of stay],” the authors concluded.