Impact of an Early and Extended Rehabilitation Program Combining Individually Tailored Nutrition and Physical Activities on Patient Outcomes After Invasive Mechanical Ventilation and Vasopressor Therapy in the ICU

NCT ID: NCT06581939

Last Updated: 2026-01-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

830 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-12-14

Study Completion Date

2027-12-14

Brief Summary

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The NUTRIREA-4 trial will test the hypothesis that an individually tailored rehabilitation program combining nutritional therapy, physiotherapy, and physical activity and started early in the ICU then continued uninterruptedly throughout the post-ICU stay and at home after hospital discharge improves the long-term outcomes of critical-illness survivors, compared to usual care.

From ICU admission to recovery at home, the trial patients will receive either usual care or the early extended rehabilitation program. Usual care will consist in nutritional support and physiotherapy according to usual local practice in each participating ICU. The early extended program will consist of nutritional therapy, physiotherapy, and physical activity according to a standardized protocol tailored to general- and muscle-health improvements achieved in each individual patient over time.

Detailed Description

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Conditions

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Mechanical Ventilation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Rehabilitation group

Individualized rehabilitation program

Group Type EXPERIMENTAL

Rehabilitation group

Intervention Type PROCEDURE

In the rehabilitation group, patients will follow an individualized rehabilitation program started early in the ICU and continued in the post-ICU ward then at home for 12 weeks, combining goal-directed nutrition and physical activity, tailored to gains made over time by each patient, with the involvement of dieticians, physiotherapists, and adapted-physical-activity instructors.

Control group

Usual care

Group Type ACTIVE_COMPARATOR

Control group

Intervention Type PROCEDURE

In the control group, patients will receive usual care from day-0 to day-180.

Interventions

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Rehabilitation group

In the rehabilitation group, patients will follow an individualized rehabilitation program started early in the ICU and continued in the post-ICU ward then at home for 12 weeks, combining goal-directed nutrition and physical activity, tailored to gains made over time by each patient, with the involvement of dieticians, physiotherapists, and adapted-physical-activity instructors.

Intervention Type PROCEDURE

Control group

In the control group, patients will receive usual care from day-0 to day-180.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Invasive mechanical ventilation (MV) started in the ICU within the past 24 h, or started before ICU admission with ICU admission within the past 24 h, and expected to be required for at least 48 hours after randomization
* Treatment with a vasoactive agent for shock (adrenaline, dobutamine, or noradrenaline)
* Nutritional support expected to be started within 24 h after intubation (or within 24 h after ICU admission if intubation occurred before ICU admission)
* Age 18 or older
* Patient and/or next-of-kin informed about the trial and having consented to participation in the trial. If the patient is unable to receive information and no next-of-kin can be contacted during screening for the trial, trial inclusion will be completed as an emergency procedure by the ICU physician, in compliance with French law.
* Covered by the French public health-insurance system

Exclusion Criteria

* MV started more than 24 hours earlier
* Specific nutritional needs, such as pre-existing long-term home enteral or parenteral nutrition for chronic bowel disease
* Dying patient, do-not-resuscitate order, or other treatment- limitation decision at ICU admission
* Social circumstances hindering follow-up and telephone/video consultations (no fixed address, non-European residence)
* Inability to provide a stable personal mobile phone number (temporary number or not in the owner's name)
* Communication difficulties via telephone or video consultation (pre-existing severe hearing or visual impairment)
* Pre-existing chronic illness with life expectancy \<6 months
* Pre-existing cognitive impairment
* Pre-existing spinal injury
* Inability to walk before the critical illness
* Acute or chronic neuromuscular disease
* Brain injury, e.g., due to cardiac arrest, stroke, or severe trauma
* Pregnancy, recent delivery, or lactation
* Adult under guardianship
* Correctional facility inmate
* Institutionalized patient
* Prior inclusion in a randomized trial designed to compare rehabilitation programs delivered to patients during critical illness
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Nantes University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jean REIGNIER, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Nantes University Hospital

Locations

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CH d'Albi

Albi, , France

Site Status RECRUITING

CHU d'Amiens - Site Sud

Amiens, , France

Site Status RECRUITING

CHU d'Amiens

Amiens, , France

Site Status RECRUITING

CHU d'Angers

Angers, , France

Site Status RECRUITING

CH d'Angoulème

Angoulême, , France

Site Status RECRUITING

CH d'Argenteuil

Argenteuil, , France

Site Status RECRUITING

CH de Belfort

Belfort, , France

Site Status RECRUITING

CHU de Besançon

Besançon, , France

Site Status RECRUITING

CH de Béthune

Béthune, , France

Site Status RECRUITING

CHU de Bordeaux - Hôpital Pellegrin

Bordeaux, , France

Site Status RECRUITING

Centre Hospitalier William Morey

Chalon-sur-Saône, , France

Site Status RECRUITING

CH de Cholet

Cholet, , France

Site Status RECRUITING

CHU de Clermont-Ferrand

Clermont-Ferrand, , France

Site Status RECRUITING

CH de Dieppe

Dieppe, , France

Site Status RECRUITING

CHU de Dijon

Dijon, , France

Site Status RECRUITING

CH d'Annecy Genevois

Épagny, , France

Site Status RECRUITING

Centre Hospitalier Sud Essonne

Étampes, , France

Site Status RECRUITING

Hôpital Raymond Poincaré - AP-HP

Garches, , France

Site Status RECRUITING

CHU de Grenoble

Grenoble, , France

Site Status RECRUITING

CH d'Haguenau

Haguenau, , France

Site Status RECRUITING

CH de Vendée

La Roche-sur-Yon, , France

Site Status RECRUITING

Hôpital de Bicêtre - AP-HP

Le Kremlin-Bicêtre, , France

Site Status RECRUITING

CH du Mans

Le Mans, , France

Site Status RECRUITING

CH de Lens

Lens, , France

Site Status RECRUITING

CHRU de Lille

Lille, , France

Site Status RECRUITING

CH de Lomme

Lomme, , France

Site Status RECRUITING

CH de Lorient

Lorient, , France

Site Status RECRUITING

CHU de Lyon

Lyon, , France

Site Status RECRUITING

CHU de Montpellier

Montpellier, , France

Site Status RECRUITING

CHU de Nantes

Nantes, , France

Site Status RECRUITING

CHU de Nice - Hôpital Pasteur

Nice, , France

Site Status RECRUITING

CHU de Nice

Nice, , France

Site Status RECRUITING

CH d'Orléans

Orléans, , France

Site Status RECRUITING

Hôpital Saint-Louis - AP-HP

Paris, , France

Site Status RECRUITING

Hôpital Cochin - AP-HP

Paris, , France

Site Status RECRUITING

Hôpital la Pitié-Salpétrière - AP-HP

Paris, , France

Site Status RECRUITING

Hôpital Tenon - AP-HP

Paris, , France

Site Status RECRUITING

CHU de Reims

Reims, , France

Site Status RECRUITING

CHU de Rennes

Rennes, , France

Site Status RECRUITING

CHU de Rouen

Rouen, , France

Site Status RECRUITING

CH de Saint-Brieuc

Saint-Brieuc, , France

Site Status RECRUITING

Hôpital Delafontaine

Saint-Denis, , France

Site Status RECRUITING

Centre Hospitalier de Saint-Nazaire

Saint-Nazaire, , France

Site Status RECRUITING

CHU de Saint-Etienne

Saint-Priest-en-Jarez, , France

Site Status RECRUITING

CH de Saint-Malo

St-Malo, , France

Site Status RECRUITING

CHU de Strasbourg - Nouvel Hôpital Civil

Strasbourg, , France

Site Status RECRUITING

CHU de Strasbourg - Hôpital de Hautepierre

Strasbourg, , France

Site Status RECRUITING

Hôpital Foch

Suresnes, , France

Site Status RECRUITING

CHU de Tours

Tours, , France

Site Status RECRUITING

CH de Valenciennes

Valenciennes, , France

Site Status RECRUITING

CH de Vannes

Vannes, , France

Site Status RECRUITING

CH de Verdun

Verdun, , France

Site Status RECRUITING

Countries

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France

Central Contacts

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Diane MAUGARS

Role: CONTACT

+33(0)253482473

Carole OUISSE

Role: CONTACT

+33(0)244768205

Facility Contacts

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Christophe HENRY

Role: primary

Julien MAIZEL

Role: primary

Stéphanie MALAQUIN

Role: primary

Marc PIERROT

Role: primary

Laurent LAINE

Role: primary

Gaëtan PLANTEFEVE

Role: primary

Julio BADIE

Role: primary

Gaël PITON

Role: primary

Ghada SBOUI

Role: primary

Vivien GUILLOTIN

Role: primary

Thomas MALDINEY

Role: primary

+33 3 85 44 66 88

Anne-Astrid BOURION

Role: primary

Bertrand SOUWEINE

Role: primary

Jean-Philippe RIGAUD

Role: primary

Jean-Pierre QUENOT

Role: primary

Marie ROUGON

Role: primary

Akli CHERMAK

Role: primary

Virginie MAXIME

Role: primary

Louis-Marie GALERNEAU

Role: primary

Quentin GEORGES

Role: primary

Isabelle VINATIER

Role: primary

Laurent GUERIN

Role: primary

Mickaël LANDAIS

Role: primary

Olivier NIGEON

Role: primary

Saad NSEIR

Role: primary

Thierry VAN DER LINDEN

Role: primary

Béatrice LACOMBE

Role: primary

Laurent ARGAUD

Role: primary

Samir JABER

Role: primary

Jean REIGNIER, MD

Role: primary

0240087361

Matthieu BOIFFIER

Role: primary

Clément SACCHERI

Role: primary

Maxime DESGROUAS

Role: primary

Michael DARMON

Role: primary

Jean-Paul MIRA

Role: primary

Elise MORAWIEC

Role: primary

BEURTON Alexandra

Role: primary

Maxime BERTRAND

Role: primary

Jean-Marc TADIE

Role: primary

Fabienne TAMION

Role: primary

Mattieu DEBARRE

Role: primary

Daniel SILVA

Role: primary

Damien MULLER

Role: primary

Guillaume THIERY

Role: primary

Nicolae-Vlad BOTOC

Role: primary

Hamid MERDJI

Role: primary

Jean-Etienne HERBRECHT

Role: primary

Jérôme DEVAQUET

Role: primary

Emmanuelle MERCIER

Role: primary

Fabien LAMBIOTTE

Role: primary

Agathe DELBOVE

Role: primary

Thibault NOEL

Role: primary

Other Identifiers

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RC23_0585

Identifier Type: -

Identifier Source: org_study_id

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