Rehabilitation Interventions for Postintensive Care Syndrome: A Systematic Review*

  title={Rehabilitation Interventions for Postintensive Care Syndrome: A Systematic Review*},
  author={Juliane Mehlhorn and Antje Freytag and Konrad F. R. Schmidt and Frank Brunkhorst and Juergen Graf and Ute Troitzsch and Peter Schlattmann and Michel Wensing and Jochen Gensichen},
  journal={Critical Care Medicine},
Objective:An increasing number of ICU patients survive and develop mental, cognitive, or physical impairments. Various interventions support recovery from this postintensive care syndrome. Physicians in charge of post-ICU patients need to know which interventions are effective. Data Sources:Systematic literature search in databases (MEDLINE, EMBASE, Cochrane CENTRAL, PsycInfo, CINAHL; 1991–2012), reference lists, and hand search. Study Selection:We included comparative studies of rehabilitation… 

Early rehabilitation for the prevention of postintensive care syndrome in critically ill patients: a study protocol for a systematic review and meta-analysis

This systematic review will present evidence on the prevention of PICS in critically ill patients with early rehabilitation and the Grading of Recommendations Assessment, Development and Evaluation approach to rate the quality of evidence.

Nonpharmacologic Interventions to Prevent or Mitigate Adverse Long-Term Outcomes Among ICU Survivors: A Systematic Review and Meta-analysis.

There is thin evidence that diaries and exercise programs have a positive effective on mental outcomes, and other commonly used nonpharmacologic interventions in daily ICU practice are not supported by conclusive evidence from this meta-analysis.

Impact of follow-up consultations for ICU survivors on post-ICU syndrome: a systematic review and meta-analysis

The evidence indicates that follow-up consultations might reduce symptoms of PTSD at 3–6 months after ICU discharge in ICU survivors, but without affecting quality of life and other outcomes investigated.

Improving Quality of Life in Patients at Risk for Post–Intensive Care Syndrome

Effective post-ICU rehabilitation of critical illness survivors: what do we know?

  • O. Bienvenu
  • Psychology, Medicine
    Critical care medicine
  • 2014
At this early stage of research, the use of ICU diaries to prevent or ameliorate posttraumatic stress disorder (PTSD) symptoms appears to be the most promising of the post-ICU interventions studied on a large scale.

Physical rehabilitation interventions for adult patients during critical illness: an overview of systematic reviews

An overview of systematic reviews evaluating the effect of physical rehabilitation interventions across the continuum of recovery provides recommendations for design of future interventional trials and SR.

Intensive Care Syndrome: Promoting Independence and Return to Employment (InS:PIRE). Early evaluation of a complex intervention

This historical control study suggests that a complex intervention may improve quality of life and self-efficacy in survivors of ICU, and is needed to investigate this intervention further.

Increased Hospital-Based Physical Rehabilitation and Information Provision After Intensive Care Unit Discharge: The RECOVER Randomized Clinical Trial.

Post-ICU hospital-based rehabilitation, including increased physical and nutritional therapy plus information provision, did not improve physical recovery or HRQOL, but improved patient satisfaction with many aspects of recovery.



Rehabilitation after critical illness: A randomized, controlled trial

A self-help rehabilitation manual is effective in aiding physical recovery and reducing depression in patients recalling delusional memories from the ICU, however, further psychological care may be needed to reduce the incidence of anxiety and PTSD-related symptoms.

Physiotherapy led early rehabilitation of the patient with critical illness

Overall, early initiation of rehabilitation reveals an increased incidence of physiotherapy consultation, decreased time to achieve activity milestones, improved functional outcomes at intensive care unit and hospital discharge and reduced direct patient costs.

Exercise rehabilitation following hospital discharge in survivors of critical illness: an integrative review

Further evidence is required both to identify which patients are most likely to benefit and to determine the optimum content and format of exercise rehabilitation programmes for patients following critical illness post-hospital discharge.

Long-term complications of critical care

Survivors of critical illness are frequently left with a legacy of long-term physical, neuropsychiatric, and quality of life impairments, which can help identify patients who are most at risk of these complications.

Functional status after intensive care: a challenge for rehabilitation professionals to improve outcome.

The high prevalence of long-lasting restrictions in physical, social and psychological functioning among patients who stayed in the intensive care unit for at least 2 days implies that these patients are a potential target population for rehabilitation medicine.

Cognitive and physical rehabilitation of intensive care unit survivors: Results of the RETURN randomized controlled pilot investigation*

A multicomponent rehabilitation program for intensive care unit survivors combining cognitive, physical, and functional training appears feasible and possibly effective in improving cognitive performance and functional outcomes in just 3 months.

Quality of life after intensive care: A systematic review of the literature

Quality of life differed on diagnostic category but, overall, critically ill patients had a lower quality of life than an age- and gender-matched population, butquality of life tended to improve over years.

Chronically critically ill patients: health-related quality of life and resource use after a disease management intervention.

The intervention was not associated with significant changes in any outcomes other than duration of readmission, but the supportive care coordination program could be provided without increasing overall charges.