Improving outcomes after critical illness: harder than we thought!

Acute Respiratory Distress Syndrome as a Precursor to Post–Intensive Care Syndrome

“…Theories around this lack of effectiveness have been proposed and include a lack of engagement with family members and loved ones, a lack of focus on social issues which survivors face during recovery, and a failure to look beyond traditional healthcare services during the recovery phase. Issues around appropriate staff involvement and the outcome measures selected in these studies have also been discussed (63).…”

Should ICU clinicians follow patients after ICU discharge? Yes

“…Recently we have learned how challenging demonstrating change can be [6]. Of interest, the PIX study of a targeted exercise programme failed to shift a physiological outcome measure, yet a parallel qualitative evaluation demonstrated clear value for those in the intervention arm; patients felt more motivated, engaged and supported [7].…”

Can the critically ill patient generate sufficient energy to facilitate exercise in the ICU?

“…improve health related quality of life in critical illness survivors 1 . All things being 50 equal, muscle mass is directly related to muscle strength, and is therefore a major 51 determinant of physical function.…”