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Multicenter Randomized controlled trial: ERIC-HF protocol results
Session:
Painel 8 - Enfermagem em Cardiologia 1
Speaker:
Bruno Miguel Delgado
Congress:
CPC 2020
Topic:
M. Cardiovascular Nursing
Theme:
32. Cardiovascular Nursing
Subtheme:
32.1 Acute Nursing Care
Session Type:
Posters
FP Number:
---
Authors:
Bruno Miguel Delgado; Ivo Lopes; Sandra Pereira; Luisa Carneiro ; Barbara Gomes; Andre Novo
Abstract
<p>Introduction<br /> Decompensated Heart Failure (HF) patients are often characterized by functional dyspnea, edema, functional dependence and impairment of performance in activities of daily living. Aerobic exercise training (AET) can benefit this patients, optimizing their functional capacity (FC), increasing exercise tolerance and promoting a better lifestyle. Although the benefits, AET is not yet validated for inpatients. ERIC-HF (early rehabilitation in cardiology – Heart Failure) is an AET program designed to HF inpatients.</p> <p><br /> Purpose</p> <p>To evaluate the feasibility, safety and impact on FC of an AET program (ERIC-HR) in decompensated HF inpatients.<br /> </p> <p>Methods</p> <p>Multicenter randomized single-blind controlled trial developed in 8 cardiology wards. The study is still ongoing and patients are randomized into training group (TG) or control (CG). Data collection include cardiovascular history, HF history and two functional tools: LCADL and Barthel Index (BI). TG patients perform ERIC-HF program twice a day for 5 days/week. ERIC-HF is a supervised AET program, with increasing levels of intensity, divided into 5 stages (respiratory training, cycloergometer training, gait training and climbing stairs). Vital signs are evaluated before and immediately after the exercise, as well as the Borg Modified Perceived Exertion (BMPE) and any adverse event. CG patients perform physical activity in accordance with the guidelines, always supervised too. At discharge, all patients are evaluated with LCADL, BI and a 6-minute walking test (6MWT). The study was published in clinicaltrials.gov with the Identifier: NCT03838003.</p> <p>Results</p> <p>Until now, 174 patients are randomized, 95 in TG and 79 in CG with an average of age of 71 (±11) years old, 96 are male, 76% are in NYHA class III, 28 have diabetes and 54 have resynchronization therapy (CRT). At admission, both groups have the same level of functional dependence according to LCADL and Barthel scores. TG patients performed a total amount of 1223 session of exercise with an average of 14 sessions each, for 14 (±12) days of hospitalization. About 32% of patients reached the final stage of the program – climbing stairs. At discharge, TG patients presented lower LCADL score, higher BI score and a 47 meters difference on the 6MWT (p=0,003) which represents a better FC. Adverse events registered are: BMPE superior to 7 in 65 sessions of exercise, new onset of atrial fibrillation in 14 sessions, transitory precordial pain in 4 sessions and fall of systolic blood pressure after exercise in 210 sessions.</p> <p>Conclusions</p> <p>The ERIC-HF program demonstrated to promote FC. Regarding safety, we can infer that the few adverse events registered aren´t major, and does not represent that AETcan be deleterious for decompensated HF patients, however more research should be done. Probably AET is safe and viable, for HF patients and must be encouraged. No other study of our knowledge has demonstrated this findings.</p> <p> </p>
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