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Table 1 Inclusion and exclusion criteria

From: Repetitive vascular occlusion stimulus (RVOS) versus standard care to prevent muscle wasting in critically ill patients (ROSProx):a study protocol for a pilot randomised controlled trial

Inclusion criteriaExclusion criteria
1. Age ≥ 18 years
2. Patient admitted to the ICU within the past 48 h
3. Personal consultee provides declaration of agreement for patient enrolment, retrospective patient consent
4. Non-invasive ventilation (CPAP) or invasive mechanical ventilation
5. At least two other organ failures as defined by scoring ≥ 1 points on two of the SOFA score domains
6. Likely to remain in the ICU for at least 4 days
1. Profound cardiovascular instability—infused vasopressors ≥ 0.5 μg/kg/min of norepinephrine; or in opinion of senior attending doctor
2. Profound coagulopathy (prothrombin time > 2.5 times normal, APTT > 2 times normal or platelet count ≤ 50), bleeding diathesis or on intravenous heparin infusion APTR ≥ 2
3. Neuromuscular condition—any previous or concurrent neurological condition or muscle disease
4. History of peripheral arterial vascular disease—any previous surgery or interventional procedure for peripheral arterial insufficiency; or any reason to clinically suspect arterial insufficiency of the leg, such as collateral history of claudication or examination findings of absent peripheral pulses
5. Prior amputation of a lower limb
6. Thigh circumference > 77 cm (technical limitations)
7. Unlikely to survive the ICU
8. Disseminated malignancy
9. Pregnancy
10. Previous, or current, deep vein thrombosis and/or pulmonary embolism
11. Positioned prone
12. Contraindication to pharmacological venous thromboembolism prophylaxis
13. Pre-existing significant cognitive impairment
14. Enrolled in a conflicting interventional trial
15. Lack of ability to communicate in verbal and written English
16. Patient hospitalised > 48 h prior to ICU admission
17. Frail skin, skin condition or soft tissue infection or other reason that prevents experimental use of upper limb
  1. APTR activated partial thromboplastin time ratio, APTT activated partial thromboplastin time, CPAP continuous positive airway pressure, ICU intensive care unit, SOFA Sequential Organ Failure Assessment