RT300 Supine Therapy in Mechanically Ventilated Patients
TryCYCLE: A Prospective Study of the Safety and Feasibility of Early In-Bed Cycling in Mechanically Ventilated Patients
Michelle E. Kho, Alexander J. Molloy, France J. Clarke, Daana Ajami, Magda McCaughan, Kristy Obrovac, Christina Murphy, Laura Camposilvan, Margaret S. Herridge, Karen K. Y. Koo, Jill Rudkowski, Andrew J. E. Seely, Jennifer M. Zanni, Marina Mourtzakis, Thomas Piraino, Deborah J. Cook, Canadian Critical Care Trails Group
PLOS ONE | 2016 Dec. 28. DOI: 10.1371/journal.pone.0167561
The objective of this study was to assess the safety and feasibility of in-bed cycling started within the first 4 days of mechanical ventilation (MV) to inform a future randomized clinical trial. The results demonstrated that early cycling within the first 4 days of MV among hemodynamically stable patients is safe and feasible.
Single center, pilot, prospective cohort study.
Twenty-one bed adult academic medical-surgical intensive care unit (ICU) in Hamilton, ON, Canada.
Thirty-three adults (>=18 years) receiving MV who walked independently pre-ICU.
87.9% with medical admitting diagnoses; 48.4% female; mean age 65.8 +/- 12.2 years; APACHE II score 24.3 +/- 6.7.
Thirty minutes of in-bed RT300 supine cycling 6 days/week in the ICU.
Primary outcomes: Safety (termination), measured as events prompting cycling termination.
Secondary Safety: Disconnection or dislodgement outcomes including catheter/tube dislodgements.
Feasibility: Measured as consent rate and fidelity to intervention.
Consent from 34 of 37 patients approached (91.9%), 33 of whom received in-bed cycling. Cycling termination was infrequent (2.0%) and no device dislodgments occurred.
Cycling began a median of 3 days after ICU admission; patients received median of 5 cycling sessions with median duration of 30.7 minutes per session.
During 205 total cycling sessions, 73.1% included invasive MV; 37.6% sedative or analgesic infusions; 2.9% vasopressors; and 2.0% dialysis.
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DISCLAIMER: The information presented here is taken from the abstract of the open access, peer-reviewed publication by Kho et al in PLOS ONE, 2016. The full-text article states that “a specialized cycle ergometer [was] purchased by our hospital (RT300 supine cycle, Restorative Therapies, Baltimore, MD)” and that Restorative Therapies loaned Dr. Kho two supine cycles for a separate multi-center study.