Effects of a Combined Lifestyle Intervention on Recovery of ICU Survivors: A Randomized Controlled Trial.

Abstract

Evidence supporting the benefits of combined nutrition and exercise programs in ICU survivors is limited. We assessed the impact of a combined lifestyle intervention on perceived physical functioning (PF) and health-related quality of life (HRQoL) post-ICU. Single-center randomized control trial. Teaching hospital in the Netherlands (Frisius Medical Centre Leeuwarden). Adult long stay ICU survivors (≥ 48 hr) with a PF score of less than 67% on the Dutch translation of the RAND-36 item Health Survey. The 12-week intervention included twice-weekly group exercise, dietary advice, and protein supplementation as needed. The control group received standard aftercare according to local protocol. Primary outcome (PF score at 12 wk) and secondary outcomes were assessed during a clinic visit at baseline and after a 12-week period. 39 patients completed the study (control, n = 20; intervention, n = 19): 26% female, median age 61 years (46-72), median ICU stay 7 days (4-14), and patients were severely ill (Acute Physiology and Chronic Health Evaluation III: 67 [50-89]). Although there were imbalances in ICU characteristics, baseline characteristics and PF scores were similar. At 12 weeks, the intervention group showed a significant improvement (p = 0.024) in PF-domain score. Daily protein intake in the intervention group increased from 82.3 (67.5-97.9) to 116.7 (107.3-138.7) g/kg (p = 0.003), with 68% meeting the minimal intake target of 1.2 g/kg/d. The data of this small-sample size randomized controlled trial suggest that a combined lifestyle intervention program can significantly improve PF and protein intake in ICU survivors with a prolonged PF scores below reference.