JMIR research protocols · 2026
Standardized Single-Session Cardiopulmonary Exercise Test for Measuring Peak Oxygen Uptake, Oxygen On/Off Kinetics, and Skeletal Muscle Oxygenation in ICU Survivors-ICU Combined Assessment of Cardiorespiratory Exercise (ICU-CARE) Study: Protocol for a Cross-Sectional Observational Study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Blunderfield Britney, Santana Jefferson, Majumdar Raju, Herath Isuru, Blouw Marcus, Ramsey Clare, Olafson Kendiss, Sousa Mayson, Boyd J Gordon, Rozenberg Dmitry, Cowley Kristine, Herridge Margaret S, Batt Jane, Horsburgh Mac, Duhamel Todd, Christiansen David, Villar Rodrigo, Mendelson Asher A
Аннотация
BACKGROUND: Intensive care unit-acquired weakness (ICU-AW) research focuses predominantly on intrinsic muscle pathology rather than integrated systemic interactions, which are commonly studied in exercise science. Peak oxygen uptake (V˙O2peak), V˙O2 on/off kinetics, and skeletal muscle oxygenation provide a quantitative evaluation of exercise capacity and are infrequently measured in intensive care unit (ICU) survivors. Routine cardiopulmonary exercise test (CPET) research separates V˙O2peak and V˙O2 kinetics assessments into multiple sessions. Yet, a combined experimental approach may enhance diagnosis, follow-up retention, and mechanistic insight for patients with ICU-AW.
OBJECTIVE: This prospective cross-sectional observational study aims to develop a standardized, single-session CPET protocol for combined assessment of V˙O2peak, V˙O2 kinetics, and skeletal muscle microvascular oxygenation in ICU survivors, enabling quantitative and integrated assessment of ICU-AW.
METHODS: Adults mechanically ventilated for ≥7 days will be recruited to participate 6 months post-ICU discharge in a modified CPET exercise session on an upright cycle ergometer. The proposed standardization will involve (1) the estimation of V˙O2peak using a priori formulas with a V˙O2peak correction factor for the ICU population, (2) V˙O2 on-kinetics (constant work rate) targeting relative 30% V˙O2reserve, (3) an incremental ramp exercise based on self-reported functional status, and (4) a 10-minute recovery to quantify V˙O2 off-kinetics. In addition, near-infrared spectroscopy will be placed on the vastus lateralis muscle to simultaneously collect tissue saturation index and deoxyhemoglobin during each phase of the protocol.
RESULTS: Recruitment is anticipated to begin in June 2026 and is expected to be completed in 2029/2030. The anticipated sample size will be approximately 48 participants based on the feasibility of recruiting 1 participant per month and a sample size calculation based on Bland-Altman limits of agreement between predicted and measured V˙O2peak.
CONCLUSIONS: The intensive care unit combined assessment of cardiorespiratory exercise (ICU-CARE) CPET protocol will enable the quantitative evaluation of V˙O2peak, V˙O2 on/off kinetics, and local microvascular skeletal muscle oxygenation during a single exercise session, facilitating the integrated physiological study of ICU-AW.
OBJECTIVE: This prospective cross-sectional observational study aims to develop a standardized, single-session CPET protocol for combined assessment of V˙O2peak, V˙O2 kinetics, and skeletal muscle microvascular oxygenation in ICU survivors, enabling quantitative and integrated assessment of ICU-AW.
METHODS: Adults mechanically ventilated for ≥7 days will be recruited to participate 6 months post-ICU discharge in a modified CPET exercise session on an upright cycle ergometer. The proposed standardization will involve (1) the estimation of V˙O2peak using a priori formulas with a V˙O2peak correction factor for the ICU population, (2) V˙O2 on-kinetics (constant work rate) targeting relative 30% V˙O2reserve, (3) an incremental ramp exercise based on self-reported functional status, and (4) a 10-minute recovery to quantify V˙O2 off-kinetics. In addition, near-infrared spectroscopy will be placed on the vastus lateralis muscle to simultaneously collect tissue saturation index and deoxyhemoglobin during each phase of the protocol.
RESULTS: Recruitment is anticipated to begin in June 2026 and is expected to be completed in 2029/2030. The anticipated sample size will be approximately 48 participants based on the feasibility of recruiting 1 participant per month and a sample size calculation based on Bland-Altman limits of agreement between predicted and measured V˙O2peak.
CONCLUSIONS: The intensive care unit combined assessment of cardiorespiratory exercise (ICU-CARE) CPET protocol will enable the quantitative evaluation of V˙O2peak, V˙O2 on/off kinetics, and local microvascular skeletal muscle oxygenation during a single exercise session, facilitating the integrated physiological study of ICU-AW.