Effect of Early Physical Exercise on Pulmonary Ventilation and Recruitment

Study Overview
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Brief Summary
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In the critically patient bed rest and immobilization are some of the responsable of the development of respiratory complications. Early physical exercise is a tool to prevent respiratory complications as lost of respiratory muscle strength, decrease in functional residual capacity and hypoxemia improving oxygenation. New technology as electrical impedance tomography (EIT) are available to visualize changes of regional lung aeration. The aim of this study is to assess the effect of early physical exercise improving alveolar recruitment and pulmonary ventilation in intensive care unit (ICU) patients, evaluated with EIT. The ICU patients included at day of evaluation will be evaluated continuously with EIT in different positions. 1) in the supine position (at 30° of inclination), 2) Sitting in chair 3) Active physical exercise 4) And rest in chair after exercise

Official Title
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Effect of Early Physical Exercise on Pulmonary Ventilation and Recruitment Evaluated With Electric Impedance Tomography.

Conditions
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Critical Illness

Intervention / Treatment
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* Other: A: Chair - Leg Cycle ergometer
* Other: B: Chair - Arm Cycle ergometer
* Other: C: Walk in place


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient admitted at the Intensive Care Medical/Surgical Unit of Clinic Saint Luc Days of hospitalization between 1 and 10 Hemodynamically stable Patient or family member sign the informed consent Exclusion Criteria: With risk of evisceration Therapy withdrawal With cardiac devices (Pace Maker) Persistent cough Patches or open wounds in zone of electrodes Presence of high vasopressor medication (noradrenaline > 3 mg/h) PEEP > 15 cm H2 Acute Myocardial Infarction Active bleeding Intracranial pressure > 20 mm Hg or with major instability

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Legs Cycloergometer Group (A)<br>Patients randomized in this group will do 10 minutes of legs cycloergometer active exercise. Continuously evaluated with electric impedance tomography. | Other: A: Chair - Leg Cycle ergometer<br> <br> * Other names: Early mobility therapy;|
| Experimental: Hands Cycloergometer Group (B)<br>Patients randomized in this group will do 10 minutes of hand cycloergometer active exercise. Continuously evaluated with electric impedance tomography. | Other: B: Chair - Arm Cycle ergometer<br> <br> * Other names: Early mobility therapy;|
| Experimental: Walk in place (C)<br>Patients randomized in this group will do 10 minutes of active walk in place. Continuously evaluated with electric impedance tomography. | Other: C: Walk in place<br> <br> * Other names: Early mobility therapy;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in pulmonary electric impedance tomography (EIT) before, during and after single session of exercise. | The change in pulmonary recruitment and ventilation will be evaluated with electric impedance tomography (EIT) in single session of exercise. First measure will be made for five minutes with EIT, before the exercise, then second measure will be made during exercise for ten minutes with EIT and finally last measure will be made after exercise for twenty minutes with EIT. All impedanciometries obtained in the patient in different activities will compare each. | Meassure of EIT after 10 minutes of exercise and will be compared with baseline EIT | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in PaO2 before, during and after single session of exercise | Before exercise will be taken a sample of arterial blood gases for determinate the initial PaO2 of the patient. Twenty minutes after exercise will be taken a new sample of arterial blood gases to establish the difference between PaO2 before exercise and after exercise. | Measure of PaO2 after 20 minutes of exercise and will compared with baseline PaO2 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Early Physical Exercise, Alveolar Recruitment, Electrical Impedance Tomography, Oxygenation, Ventilation