Guideline on multimodal rehabilitation for patients with post-intensive care syndrome

Critical Care

Guideline

Andreas Schäfer¹  Claus Wallesch²  Ricki Nusser-Müller-Busch³  Maria-Dorothea Heidler⁴  Bettina Scheffler⁵  Peter S. Sandor⁶  Karin Diserens⁷  Marie-Madlen Jeitziner⁸  Caroline Renner⁹  Monika Albert^1,10  Imanuel Dzialowski^1,11  Martina Lück^1,12  Gudrun Zimmermann^1,13  Peter Nydahl^1,14  Sabine Brinkmann^1,15 

[1] Asklepios Center for Further Education in Intensive Care - and Anaesthesia Nursing North Hesse, Frankfurt, Germany;BDH-Hospital Elzach - Center for Neurorehabilitation and Intensive Care, Elzach, Germany;Berlin, Germany;Brandenburg Klinik, Bernau, Germany;Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany;Department Neurology and Psych. ZURZACH Care, Bad Zurzach, Switzerland;Department of Clinical Neurosciences, University Hospital, Lausanne, Switzerland;Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland;Institute of Nursing Science, Department of Public Health, Faculty of Medicine, University of Basel, Basel, Switzerland;Department of Neurology and Neuro-Rehabilitation, Herz-Kreislauf-Zentrum, Klinikum Hersfeld-Rotenburg GmbH, Rotenburg a. F., University of Leipzig, Leipzig, Germany;Department of Neurology, Rehabilitation ZURZACH Care, Baden, Switzerland;ELBLAND Neuro-Rehabilitation Center Grossenhain, Academic Teaching Hospital Technical University Dresden, Dresden, Germany;Fachklinik Bad Heilbrunn, Heilbrunn, Germany;IB University of Health and Applied Social Science Berlin, Hamburg, Cologne, Stuttgart, Munich, Germany;Nursing Research, University Hospital of Schleswig-Holstein, Arnold-Heller-Str. 3, 24105, Kiel, Germany;Institute of Nursing Science and Development, Paracelsus Medical University, Salzburg, Austria;University of Applied Sciences, Osnabrück, Germany;

关键词: Critical care;    Guidelines;    Intensive care;    Physical therapy;    PICS;    Post-intensive care syndrome;    Psychological therapy;    Rehabilitation;   

DOI  :  10.1186/s13054-023-04569-5

 received in 2023-05-26, accepted in 2023-07-07,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundIntensive Care Unit (ICU) survivors often experience several impairments in their physical, cognitive, and psychological health status, which are labeled as post-intensive care syndrome (PICS). The aim of this work is to develop a multidisciplinary and -professional guideline for the rehabilitative therapy of PICS.MethodsA multidisciplinary/-professional task force of 15 healthcare professionals applied a structured, evidence-based approach to address 10 scientific questions. For each PICO-question (Population, Intervention, Comparison, and Outcome), best available evidence was identified. Recommendations were rated as “strong recommendation”, “recommendation” or “therapy option”, based on Grading of Recommendations, Assessment, Development and Evaluation principles. In addition, evidence gaps were identified.ResultsThe evidence resulted in 12 recommendations, 4 therapy options, and one statement for the prevention or treatment of PICS. Recommendations: early mobilization, motor training, and nutrition/dysphagia management should be performed. Delirium prophylaxis focuses on behavioral interventions. ICU diaries can prevent/treat psychological health issues like anxiety and post-traumatic stress disorders. Early rehabilitation approaches as well as long-term access to specialized rehabilitation centers are recommended. Therapy options include additional physical rehabilitation interventions. Statement: A prerequisite for the treatment of PICS are the regular and repeated assessments of the physical, cognitive and psychological health in patients at risk for or having PICS.ConclusionsPICS is a variable and complex syndrome that requires an individual multidisciplinary, and multiprofessional approach. Rehabilitation of PICS should include an assessment and therapy of motor-, cognitive-, and psychological health impairments.

【 授权许可】

CC BY   
© The Author(s) 2023

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