The number of patients who survive after a stay in the intensive care unit (ICU) is rising.1 After leaving the ICU they continue to experience the effects of their primary illness and of interventions they received, and they have higher mortality rates and longer physical and psychological recovery times than the general healthy population.2 Only 49% of patients treated in the ICU for acute respiratory distress syndrome return to work a year after leaving hospital.2 Family members also experience psychological disturbances.3 Thus, these patients represent a financial and social burden that extends beyond their initial illness.

Little research has been published about long term management in these patients: one randomised controlled trial,4 a clinical summary,5 and a few protocols. The trial’s results …