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Research ArticleOriginal Research

The Effect of High Protein and Mobility-Based Rehabilitation on Clinical Outcomes in Survivors of Critical Illness

Stephanie Wappel, Dena H Tran, Chris L Wells and Avelino C Verceles
Respiratory Care January 2021, 66 (1) 73-78; DOI: https://doi.org/10.4187/respcare.07840
Stephanie Wappel
Department of Pulmonary, Critical Care and Sleep Medicine, Greater Baltimore Medical Center, Towson, Maryland.
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Dena H Tran
Department of Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, Maryland.
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Chris L Wells
Department of Physical Therapy, University of Maryland Medical Center, Baltimore, Maryland.
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Avelino C Verceles
Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
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  • For correspondence: [email protected]
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Abstract

BACKGROUND: Protein supplementation and mobility-based rehabilitation programs (MRP) individually improve functional outcomes in survivors of critical illness. We hypothesized that combining MRP therapy with high protein supplementation is associated with greater weaning success from prolonged mechanical ventilation (PMV) and increased discharge home in this population.

METHODS: We conducted a retrospective analysis assessing the effects of an MRP on a cohort of survivors of critical illness. All received usual care (UC) rehabilitation. The MRP group received 3 additional MRP sessions each week for a maximum of 8 weeks. Subjects were prescribed nutrition and classified as receiving high protein (HPRO) or low protein (LPRO), based on a recommended 1.0 g/kg/d, and then the subjects were categorized into 4 groups: MRP+HPRO, MRP+LPRO, UC+HPRO, and UC+LPRO.

RESULTS: A total of 32 subjects were enrolled. The MRP+HPRO group had greater weaning success (90% vs 38%, P = .045) and a higher rate of discharge home (70% vs 13%, P = .037) compared to UC+LPRO group. The MRP+HPRO group had a higher, nonsignificant rate of discharge home compared to the MRP+LPRO (70% vs 20%, P = .10).

CONCLUSIONS: Combining high protein with mobility-based rehabilitation was associated with increased rates of discharge home and ventilator weaning success in survivors of critical illness. Further studies are needed to evaluate the role of combined exercise and nutrition interventions in this population.

  • rehabilitation
  • nutrition therapy
  • mechanical ventilation
  • weaning
  • critical illness
  • patient discharge

Footnotes

  • Correspondence: Avelino C Verceles MD MSc, Division of Pulmonary, Critical Care and Sleep Medicine, University of Maryland School of Medicine, 110 South Paca St, Baltimore, MD 21201. E-mail: avercele{at}som.umaryland.edu
  • Dr Verceles was supported by an NIH/NIA GEMSSTAR Award (R03AG045100), a Pepper Scholar Award from the University of Maryland Claude D. Pepper Older Americans Independence Center (NIH/NIA P30AG028747), a National Institute on Aging Award (R21AG050890), a GRECC Special Fellowship in Geriatrics, and a T. Franklin Williams Scholar Award. Dr Verceles has disclosed relationships with Atlantic Philanthropies, the John A Hartford Foundation, the Alliance for Academic Internal Medicine-Association of Specialty Professors, and the American Thoracic Society Foundation. Dr Wells also received support from NIA P30AG028747. The other authors have disclosed no conflicts of interest.

  • Copyright © 2021 by Daedalus Enterprises
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Respiratory Care: 66 (1)
Respiratory Care
Vol. 66, Issue 1
1 Jan 2021
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The Effect of High Protein and Mobility-Based Rehabilitation on Clinical Outcomes in Survivors of Critical Illness
Stephanie Wappel, Dena H Tran, Chris L Wells, Avelino C Verceles
Respiratory Care Jan 2021, 66 (1) 73-78; DOI: 10.4187/respcare.07840

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The Effect of High Protein and Mobility-Based Rehabilitation on Clinical Outcomes in Survivors of Critical Illness
Stephanie Wappel, Dena H Tran, Chris L Wells, Avelino C Verceles
Respiratory Care Jan 2021, 66 (1) 73-78; DOI: 10.4187/respcare.07840
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Keywords

  • rehabilitation
  • nutrition therapy
  • mechanical ventilation
  • weaning
  • critical illness
  • patient discharge

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