Looking at the Physiological Response of Ergometry in Critical Care Patients

Study Overview
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Brief Summary
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Exploring the physiological and metabolic demands of passive ergometry in the critical ill patient.

Detailed Description
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This study explores the physiological and metabolic demands of passive ergometry as a step in active rehabilitation and compares two methods of monitoring these changes in critically ill patients.

Official Title
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A Prospective Observational Cohort Study - Does Early Limb Ergometry Affect Oxygen Delivery and Uptake in Intubated Critically Ill Patients?

Conditions
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Critical Ill Patients

Intervention / Treatment
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* Device: Motomed cycle ergometer (MOTOmed letto2 - Reck, Reckstr 1-5, Betzenweiler 88422, Germany).


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria already on the Early Mobility Programme (EMP) cardiovascularly stable (stable vasopressor dose for two hours) stable heart rate (<140 bpm) and heart rhythm presence of a jugular central venous pressure (CVP) line and arterial line. Exclusion Criteria prior rapidly deteriorating neuromuscular disease upper limb problem precluding cycle ergometry pyrexia (temp >38 °C) raised intracranial pressure poor prognostic outcomes lack of agreement from clinician Next of kin/Legal representative (NOK/LR) not understanding English.
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Device: Motomed cycle ergometer (MOTOmed letto2 - Reck, Reckstr 1-5, Betzenweiler 88422, Germany).|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Physiological demands of early passive ergometry use in the critically ill patient. | Haemodynamic measurements collected were arterial systolic and diastolic blood pressure (SBP/DBP mmHg). | Minute by minute measurements were taken over the 60 minute data collection period. | 
| Physiological demands of early passive ergometry use in the critically ill patient. | Haemodynamic measurements collected were heart rate (HR beats/min). | Minute by minute measurements were taken over the 60 minute data collection period. | 
| Physiological demands of early passive ergometry use in the critically ill patient. | Haemodynamic measurements collected were cardiac output (CO L/min). | Minute by minute measurements were taken over the 60 minute data collection period. | 
| Physiological demandsof early passive ergometry use in the critically ill patient. | Respiratory measurements collected were stroke volume (SV m/L). | Minute by minute measurements were taken over the 60 minute data collection period. | 
| Physiological demands of early passive ergometry use in the critically ill patient. | Respiratory measurements collected were respiratory rate (RR breaths/min). | Minute by minute measurements were taken over the 60 minute data collection period. | 
| Physiological demands of early passive ergometry use in the critically ill patient. | Respiratory measurements collected were minute volume (MV L/min) and tidal volume (VT L/min). | Minute by minute measurements were taken over the 60 minute data collection period. | 
| Physiological demands of early passive ergometry use in the critically ill patient. | Metabolic measurements collected were oxygen delivery (DO2 m/L) and oxygen uptake (VO2 m/L). | Minute by minute measurements were taken over the 60 minute data collection period. | 
| Physiological demands of early passive ergometry use in the critically ill patient. | Metabolic measurements collected were central venous oxygen saturation (ScvO2 %). | Minute by minute measurements were taken over the 60 minute data collection period. | 
| Physiological demands of early passive ergometry use in the critically ill patient. | Metabolic measurements collected were CO2 production (VCO2 mL/min). | Minute by minute measurements were taken over the 60 minute data collection period. | 
| Physiological demands of early passive ergometry use in the critically ill patient. | Paired venous and arterial blood gas samples were collected. | These were taken every 10 minutes over the 60 minute data collection period. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Comparing two methods of measuring oxygen uptake (VO2 mL/min) and oxygen delivery (DO2 mL/min) during one passive ergometry session in the critically ill patient. | Oxygen uptake (VO2) was calculated by two methods. Method one calculated VO2 with the value of CO from the LiDCO™ using the modified technique of the Fick equation using paired central mixed venous and arterial blood gas samples: VO2 mL/min = CO x (CaO2 - CvO2) x10. Method two calculated VO2 by the E-COVX metabolic module via the ventilator from the value of fraction of inspired O2 (FiO2), expiratory minute volume (MV), expired concentrations of O2 (FeO2) and CO2 (FeCO2) using the equation: VO2 ml/min= MV (FiO2 -FeO2 - FiO2 (FeCO2))/1-FiO2. | Minute by minute haemodynamic and metabolic measurements were taken over the 60 minute data collection period. Paired venous and arterial blood gas samples were taken every 10 minutes over the 60 minute data collection period. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Early rehabilitation, Physiological response, Critical care