Early Rehabilitation in the Intensive Care Unit: Preventing Physical and Mental Health Impairments

Abstract

Survivors of critical illness often experience new or worsening impairments in physical, cognitive and/or mental health, referred to as post-intensive care syndrome (PICS). Such impairments can be long-lasting and negatively impact survivors' quality of life. Early rehabilitation in the intensive care unit (ICU), while patients remain on life-support therapies, may reduce the complications associated with PICS. This article addresses evidence-based rehabilitation interventions to reduce the physical and mental health impairments associated with PICS. Implementation of effective early rehabilitation interventions targeting physical impairments requires consideration of 5 factors: barriers, benefits, feasibility, safety, and resources. Mental health impairments may be addressed by the following interventions: ICU diaries, early in-ICU psychological intervention, and post-ICU coping skills training. In both cases, a multidisciplinary team-based approach is paramount to the successful incorporation of early rehabilitation into routine practice in the ICU.

Keywords: ICU diary; anxiety; critical illness; depression; mental health; mobility; muscle weakness; physical therapy modalities; post-intensive care syndrome; post-traumatic stress disorder; rehabilitation.

Conflict of interest statement

Conflict of Interest

A Parker declares no conflicts of interest.

T Sricharoenchai declares no conflicts of interest.

DM Needham declares no conflicts of interest.