Returning to Everyday Tasks Utilizing Rehabilitation Networks-III (RETURN-III)

Description

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 VA patients with ICU-LTCI. The investigators hypothesize that this intervention could improve cognition, and brain structure shown by MRI. This research has high potential to influence rehabilitation strategies for Veteran and civilian ICU survivors.

Conditions

Cognitive Rehabilitation, ICU Survivorship, Intensive Care Unit, ICU

Study Overview

Study Details

Study overview

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 VA patients with ICU-LTCI. The investigators hypothesize that this intervention could improve cognition, and brain structure shown by MRI. This research has high potential to influence rehabilitation strategies for Veteran and civilian ICU survivors.

Returning to Everyday Tasks Utilizing Rehabilitation Networks-III Pilot Randomized Clinical Trial (RETURN-III Pilot RCT)

Returning to Everyday Tasks Utilizing Rehabilitation Networks-III (RETURN-III)

Condition
Cognitive Rehabilitation
Intervention / Treatment

-

Contacts and Locations

Nashville

Tennessee Valley Healthcare System Nashville Campus, Nashville, TN, Nashville, Tennessee, United States, 37212-2637

Nashville

Vanderbilt University Medical Center, Nashville, Tennessee, United States, 37212

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility 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
  • * No history of pre-existing severe cognitive impairment (IQCODE\<3.3, 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
  • * Severe substance abuse or neuropsychiatric disorder of a severity that prevents independent living
  • * Active suicidal ideation
  • * Any past or present behavior that may be deemed a safety risk for follow-up
  • * Blind, deaf, or unable to understand/communicate in English
  • * Required ICU level care less than 24 hours
  • * Not capable of completing computer-based training

Ages Eligible for Study

18 Years to

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

VA Office of Research and Development,

E. Wesley Ely, MD MPH, PRINCIPAL_INVESTIGATOR, Tennessee Valley Healthcare System Nashville Campus, Nashville, TN

Mayur B Patel, MD MPH, PRINCIPAL_INVESTIGATOR, Tennessee Valley Healthcare System Nashville Campus, Nashville, TN

Study Record Dates

2026-12-31