Reduction of Muscle Catabolism Through Brain Activation in Burn Patients

Starting soon · Not applicable

Conditions studied: Burns - Multiple, Critical Illness, Muscle Weakness

In brief

Patients with extensive burn injuries frequently develop severe skeletal muscle wasting and weakness as part of critical illness-related myopathy and neuropathy. This condition delays ventilator weaning, prolongs intensive care unit (ICU) and hospital stay, and contributes to long-term functional impairment and reduced quality of life. In burn patients, muscle loss is particularly pronounced during the early post-injury phase and is associated with mitochondrial dysfunction and altered neuromuscular signaling. Effective strategies to prevent muscle catabolism in critically ill burn patients remain limited. Although early active rehabilitation is beneficial, many patients are unable to participate due to deep sedation, mechanical ventilation, or clinical instability. Therefore, innovative rehabilitation approaches applicable during the acute phase of critical illness are needed. The REMBRANT (REduction of Muscle catabolism through BRAin activation in burn patieNTs) study is a single-center, randomized, controlled, open-label clinical trial evaluating whether a multimodal brain-activating rehabilitation strategy can attenuate skeletal muscle loss in adult patients with severe burns. Thirty patients with burns involving more than 30% of total body surface area who require invasive mechanical ventilation and prolonged sedation will be randomized in a 1:1 ratio to standard care or an intervention group. Both groups will receive standardized burn treatment and conventional rehabilitation. The intervention group will additionally receive the Burn-Bundle Extended Rehabilitation Program, combining inhalational isoflurane sedation with functional proprioceptive stimulation, repetitive transcranial magnetic stimulation, and virtual reality-assisted rehabilitation when clinically feasible. The primary outcome is change in skeletal muscle mass and strength. Secondary outcomes include ICU length of stay, ventilator-free days, mitochondrial function, and health-related quality of life.

Key facts

Study ID

NCT07435402

Run by

Charles University, Czech Republic

People needed

30

Starts

2026-05-01

Expected to finish

2030-06-30

Last updated by the study team

2026-02-27

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Adults aged 18 years or older
• Severe burn injury involving more than 30% of total body surface area (TBSA)
• Admission to the intensive care unit
• Expected need for invasive mechanical ventilation and continuous sedation for at least 7 days
• Ability to obtain written informed consent from the patient or a legally authorized representative

You may not qualify if…

• Pre-existing severe neuromuscular or neurodegenerative disease
• Known contraindication to inhalational sedation with isoflurane
• Pregnancy or breastfeeding
• Participation in another interventional clinical trial that could interfere with the study outcomes
• Any condition that, in the opinion of the investigator, would make participation in the study unsafe or interfere with protocol adherence

Where it is running

• University Hospital Královské Vinohrady — Prague, Česká Republika, Czechia

Full record on ClinicalTrials.gov

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