Returning to Everyday Tasks Utilizing Rehabilitation Networks-III Pilot Randomized Clinical Trial (RETURN-III Pilot RCT)
VA Office of Research and Development
Summary
Millions of patients survive care in medical and surgical Intensive Care Units (ICUs) every year, only to suffer from a new or accelerated dementia-like process, called post-ICU long-term cognitive impairment (ICU-LTCI). ICU-LTCI causes considerable problems with personal relationships, return to work, and everyday tasks, such as managing medicines and money. No treatment for these patients is currently available. Technology using computerized cognitive rehabilitation could improve ICU-LTCI by harnessing the healing potential of the brain (i.e., neuroplasticity). This intervention is scalable, portable, and economical. The investigators will evaluate the effectiveness of computerized cognitive rehabilitation in a randomized controlled trial of 160 ICU survivors. The investigators hypothesize that this intervention could improve cognition. This research has high potential to influence rehabilitation strategies for Veteran and civilian ICU survivors.
Description
Over a lifetime, an average American will be admitted to an intensive care unit (ICU) twice, will spend nearly a week in an ICU during their last six months of life, and will have a one in five chance of an ICU-related death. Of those millions who annually survive critical illness, ICU survivorship is marked by an inability to manage medication, handle finances, live independently, and maintain employment due to post-ICU long-term cognitive impairment (ICU-LTCI). Data from the investigators' group and others show that 50% of ICU survivors suffer from ICU-LTCI. The investigators' Veterans Affa…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Adults with a recent ICU stay (Medical or Surgical) requiring treatment for respiratory failure and/or shock (i.e., high-risk population) * No longer requiring ICU-level care Exclusion Criteria: * History of pre-existing severe cognitive impairment (IQCODE\>=3.8 or documentation in medical record) * Unwilling to commit to participation in the intervention * Under consideration for hospice * Primary residence over 100 miles from enrolling site if the patient is unwilling to return to the enrolling site for follow-up * Homeless without a secondary contact available * Sev…
Interventions
- OtherTreatment Arm: Computerized Cognitive Rehabilitation
Treatment Arm: Computerized Cognitive Rehabilitation
- OtherActive Control computer games
Active Control computer games
Locations (2)
- Tennessee Valley Healthcare System Nashville Campus, Nashville, TNNashville, Tennessee
- Vanderbilt University Medical CenterNashville, Tennessee