Rehabilitation after critical illness
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n910 (Published 15 April 2021) Cite this as: BMJ 2021;373:n910Read our latest coverage of the coronavirus outbreak
- Catherine White, trustee and information manager (volunteer)1,
- Bronwen Connolly, senior lecturer2,
- Matthew James Rowland, clinical lecturer3
- 1ICUsteps, Warwick, UK
- 2Wellcome-Wolfson Institute for Experimental Medicine, Queen’s University Belfast, Belfast, UK
- 3Kadoorie Centre for Critical Care Research, University of Oxford, John Radcliffe Hospital, Oxford, UK
- Correspondence to: C White catherine.white{at}icusteps.org
Covid-19 has raised public awareness about critical illness, but there has been less focus on establishing the services and infrastructure required to support patients in their recovery after hospital discharge. The burden experienced by patients who survive critical illness is well documented.12 The symptoms are collectively known as post-intensive care syndrome and can include long term physical impairments such as muscle weakness, weight loss, breathlessness3; cognitive impairment such as problems with memory, attention, and executive function4; and psychological symptoms such as depression5 or anxiety.6 Those recovering from covid 19 are also more likely have additional respiratory sequelae.789 Furthermore, deficits in quality of life can persist for up to 12 years after critical illness10 with many people unable to return to work.11 Families of patients can also be deeply affected by their experience.12
In 2009 guidance from the National Institute for Health and Care Excellence (NICE)13 outlined the requirements for optimum rehabilitation services after critical illness. These included …