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

Inclusion Criteria:

• Invasive mechanical ventilation (MV) started in the ICU within the past 24 h, orstarted before ICU admission with ICU admission within the past 24 h, and expectedto be required for at least 48 hours after randomization

• Treatment with a vasoactive agent for shock (adrenaline, dobutamine, ornoradrenaline)

• 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 toparticipation in the trial. If the patient is unable to receive information and nonext-of-kin can be contacted during screening for the trial, trial inclusion will becompleted as an emergency procedure by the ICU physician, in compliance with Frenchlaw.

• 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 orparenteral nutrition for chronic bowel disease

• Dying patient, do-not-resuscitate order, or other treatment- limitation decision atICU admission

• Social circumstances hindering follow-up and telephone/video consultations (no fixedaddress, non-European residence)

• Inability to provide a stable personal mobile phone number (temporary number or notin the owner's name)

• Communication difficulties via telephone or video consultation (pre-existing severehearing 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 programsdelivered to patients during critical illness