SEPTIC SHOCK Clinical Trial
Official title:
Effect of Early Physical Activity on Skeletal Muscle Signaling Pathways Controlling Protein Turnover in Patients With Sepsis.
It is clearly shown that patients in the Intensive care Unit (ICU) with severe sepsis or
multi organic failure are very susceptible to develop neuromuscular complications. That can
be attributed to a hyper catabolic state, general inflammation and immobilization. This can
leads a significant muscle wasting, polyneuropathy and/or myopathy. These alterations have
been defined with the term Intensive Care Acquired Weakness (ICUAW) and can leads important
functional squeals and impaired quality of life for months, years and in some cases
irreversibly.
To overcome these complications, early activation by physiotherapy becomes an important
tool. This type of treatment has been show to be feasible, safe and improves the functional
capacity of patients. In addition to a reduction in the duration of ICU and hospital stay
and improved quality of life for patients.
The objective of this study is to demonstrate that the early and active physical activity in
patients with severe sepsis can limit the loss of muscle mass and complications related to
this type of damage.
Procedures: Patients or relatives will be asked to participate in the study. If a positive
response is done, patients will be randomized in an intervention or control group.
A baseline evaluation will be performed during the first day of study admission. That
includes a physical exploration, electrophysiological studies, skeletal muscle
histological/biochemical evaluations and monitoring of blood biomarkers and others clinical
outcomes will be registered.
Intervention will be divided in a morning and afternoon times, patient will be positioned in
chair or bed and mobilized by physiotherapist. As usual, all patients will be attaining
manual mobilization for 20 minutes twice a day. Only for intervention group, additional
cycle-ergometer exercise will be performed for 30 minutes at better performance achieved and
tolerated for patient. All vitals parameters will be strictly controlled before, during and
after intervention.
The same baseline evaluation will be repeated after day 7 and clinical outcomes will be
registered until ICU discharge.
n/a
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Basic Science
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