An implementation-effectiveness trial investigating feasibility, safety and efficacy of Best pRacticE guideline cAre physioTHErapy with addition of protocolised ventilator hyperinflation on patient-important outcomes for critically ill adults intUbated and ventilated with Pneumonia. (BREATHE UP)
Abstract
Pneumonia is a common cause for intensive care unit (ICU) admission for breathing support from a mechanical ventilator, resulting in high morbidity, mortality, and healthcare costs. Physiotherapists working in ICU treat patients with critical pneumonia using a range of respiratory treatments to improve breathing, hasten weaning from the ventilator, and restore functional independence. Evidence supports the short-term benefits of these treatments, however currently no standard of physiotherapy practice exists for these ICU patients. Despite a plethora of studies which have shown that physiotherapy treatments, such as ventilator lung hyperinflation (VHI), aid the lungs to work better short-term, there are no studies to date which investigate the effect of these important treatments on meaningful patient-important outcomes, such as earlier weaning from the ventilator, earlier hospital discharge, less breathlessness and lung secretions, short- and longer-term disability, health-related quality of life and survival. Through previous multiphase mixed-methods research, a clinical practice guideline was developed outlining best physiotherapy practice for this ICU patient cohort. This proposed research involves conducting a multicentre hybrid implementation-effectiveness randomised, controlled trial which aims to: evaluate implementation of physiotherapy guideline care for management of pneumonia in ICU regarding feasibility, safety and acceptability; and to determine the safety and…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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