Prehabilitation to mitigate postintensive care syndrome in surgical patients: The rationale for a peri-critical illness pathway involving anaesthesiologists and intensive care physicians.
Humans; Intensive Care Units; Quality of Life; Critical Illness/psychology; Critical Illness/therapy; Critical Illness/rehabilitation; Critical Care/methods; Postoperative Complications/prevention & control; Postoperative Complications/psychology; Anesthesiologists; Preoperative Exercise; Physicians; Anesthesiology; Critical Care; Critical Illness; postintensive care syndrome; Postoperative Complications; Anesthesiology and Pain Medicine
Abstract :
[en] The post-intensive care syndrome (PICS) refers to the long-term physical, psychological and cognitive impairments experienced by intensive care unit (ICU) survivors, while PICS-Family (PICS-F) affects their family members. Despite preventive strategies during the ICU stay, PICS remains a significant concern impacting survivors' quality of life, increasing the healthcare costs, and complicating recovery. Prehabilitation offers a promising approach to mitigating PICS and PICS-F, especially when the ICU stay can be anticipated, such as in the case of major surgery. Recent literature indicates that prehabilitation - interventions designed to enhance patients' functional capacity before critical illness - may mitigate the risk and severity of PICS. Studies have demonstrated that prehabilitation programs can improve muscle strength, reduce anxiety levels and enhance overall quality of life in ICU survivors. Family prehabilitation (prehabilitation-F) is also introduced as a potential intervention to help families to cope with the stress of critical illness. This article aims to explore the role of multimodal prehabilitation and post-ICU follow-up in preventing and managing PICS and PICS-F, focusing on improving patient outcomes, supporting families and optimising healthcare resources. Combining prehabilitation with post-ICU follow-up in peri-critical care clinics could streamline resources and improve outcomes, creating a holistic care pathway. These clinics, focused on both pre-ICU and post-ICU care, would thus address PICS from multiple angles. However, the heterogeneity of patient populations and prehabilitation protocols present challenges in standardising the interventions. Further research is necessary to establish optimal prehabilitation strategies tailored to individual patient needs and to demonstrate their utility in terms of patient outcome.
Disciplines :
Anesthesia & intensive care
Author, co-author :
Rousseau, Anne-Françoise ; Université de Liège - ULiège > Département de pharmacie > Chimie médicale
Thierry, Gabriel ; Université de Liège - ULiège > GIGA ; Inflammation and Enhanced Rehabilitation Laboratory (Regional Anesthesia and Analgesia), GIGA-Immunobiology Thematic Unit, GIGA-Research, Liege, Belgium
Lambermont, Bernard ; Université de Liège - ULiège > Département des sciences cliniques > Sémiologie
Bonhomme, Vincent ; Université de Liège - ULiège > Département des sciences cliniques > Anesthésie et réanimation ; Anesthesia and Perioperative Neuroscience Laboratory, GIGA-Consciousness Thematic Unit, GIGA-Research, Liege, Belgium
Berger-Estilita, Joana; Institute of Anaesthesiology and Intensive Care, Salemspital, Hirslanden Medical Group, Bern, Switzerland ; Institute for Medical Education, University of Bern, Bern, Switzerland ; CINTESIS@RISE, Centre for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
Language :
English
Title :
Prehabilitation to mitigate postintensive care syndrome in surgical patients: The rationale for a peri-critical illness pathway involving anaesthesiologists and intensive care physicians.
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