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We welcome the NICE Guidelines on rehabilitation after critical illness
(1) and hope that they contribute to the recovery of people who survive
critical illness.
Our own service in a large teaching hospital provided rehabilitation
to 116 patients in 2008, with a mean age of 59 years (range 16-89). Sixty-
five patients had new onset neurological conditions, such as stroke and
spinal cord impairment. Nine patients were initially seen in intensive
care settings, where the team’s input helped to initiate safe discharges.
Patients in critical care settings often present with unusual
neurological conditions such as critical care neuropathy or central
pontine myelinosis, which might go unrecognised without the correct
professional input as outlined in the new guidelines.
The good news is that there is an increasing body of evidence that
early rehabilitation also reduces length of stay and prevents avoidable
secondary complications, benefiting patients and the health economy
overall. (2,3) We look forward to stronger links between critical care and
rehabilitation services in the future. (4)
Yours sincerely,
Rory J O’Connor, Senior Lecturer and Honorary Consultant Physician in
Rehabilitation Medicine, Denise H Ross, Clinical Specialist in
Physiotherapy, Chris Walshaw, Clinical Specialist in Occupational Therapy,
Department of Rehabilitation Medicine, St James’s University Hospital,
Leeds
References
1. Tan T, Brett SJ, Stokes T, on behalf of the Guideline Development
G. Rehabilitation after critical illness: summary of NICE guidance.
British Medical Journal 2009;338:b822-
2. Kuther G, Teixido L, Luiking A, Tiebel C, Gutenbrunner C.
Rehabilitation teams in acute hospitals - advantages and limitations of
the mobile team approach. Journal of Rehabilitation Medicine
2008;39(Supplement):47
3. Ross D, Heward K, Salawu Y, Chamberlain MA, Bhakta B. Upfront and
enabling: delivering specialist multidisciplinary neurological
rehabilitation. International Journal of Therapy and Rehabilitation
2009;16(2):107-113
4. New PW. The Assessment and Selection of Potential Rehabilitation
Patients in Acute Hospitals: A Literature Review and Commentary. The Open
Rehabilitation Journal 2009;2:24-34
Competing interests:
RJOC, DHR, CW deliver rehabilitation interventions to patients with critical illnesses
Competing interests:
No competing interests
06 April 2009
Rory J O'Connor
Senior Lecturer and Honorary Consultant Physician in Rehabilitation Medicine
Denise H Ross, Chris Walshaw
Department of Rehabilitation Medicine, St Jamess University Hospital, Leeds LS9 7TF
Tan et al have provided a useful summary and offered guidance for rehabilitation after critical illness. The assessment and selection of potential rehabilitation patients in acute hospitals has received little attention in the medical literature, yet is important to optimise patients outcomes and resource utilisation. Readers interested in this topic may wish to read my recent review that provides further detail (New PW. The Assessment and Selection of Potential Rehabilitation Patients in Acute Hospitals: A Literature Review and Commentary. The Open Rehabilitation Journal. 2009; 2: 24-34).
Competing interests:
None declared
Competing interests:
No competing interests
31 March 2009
Peter W New
Head, Acute Rehabilitation, Continuing Care Program
Rehabilitation after Critical Illness
Dear Editor,
We welcome the NICE Guidelines on rehabilitation after critical illness
(1) and hope that they contribute to the recovery of people who survive
critical illness.
Our own service in a large teaching hospital provided rehabilitation
to 116 patients in 2008, with a mean age of 59 years (range 16-89). Sixty-
five patients had new onset neurological conditions, such as stroke and
spinal cord impairment. Nine patients were initially seen in intensive
care settings, where the team’s input helped to initiate safe discharges.
Patients in critical care settings often present with unusual
neurological conditions such as critical care neuropathy or central
pontine myelinosis, which might go unrecognised without the correct
professional input as outlined in the new guidelines.
The good news is that there is an increasing body of evidence that
early rehabilitation also reduces length of stay and prevents avoidable
secondary complications, benefiting patients and the health economy
overall. (2,3) We look forward to stronger links between critical care and
rehabilitation services in the future. (4)
Yours sincerely,
Rory J O’Connor, Senior Lecturer and Honorary Consultant Physician in
Rehabilitation Medicine, Denise H Ross, Clinical Specialist in
Physiotherapy, Chris Walshaw, Clinical Specialist in Occupational Therapy,
Department of Rehabilitation Medicine, St James’s University Hospital,
Leeds
References
1. Tan T, Brett SJ, Stokes T, on behalf of the Guideline Development
G. Rehabilitation after critical illness: summary of NICE guidance.
British Medical Journal 2009;338:b822-
2. Kuther G, Teixido L, Luiking A, Tiebel C, Gutenbrunner C.
Rehabilitation teams in acute hospitals - advantages and limitations of
the mobile team approach. Journal of Rehabilitation Medicine
2008;39(Supplement):47
3. Ross D, Heward K, Salawu Y, Chamberlain MA, Bhakta B. Upfront and
enabling: delivering specialist multidisciplinary neurological
rehabilitation. International Journal of Therapy and Rehabilitation
2009;16(2):107-113
4. New PW. The Assessment and Selection of Potential Rehabilitation
Patients in Acute Hospitals: A Literature Review and Commentary. The Open
Rehabilitation Journal 2009;2:24-34
Competing interests:
RJOC, DHR, CW deliver rehabilitation interventions to patients with critical illnesses
Competing interests: No competing interests