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European Journal of Anaesthesiology
Article . 2025 . Peer-reviewed
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Prehabilitation to mitigate postintensive care syndrome in surgical patients

The rationale for a peri-critical illness pathway involving anaesthesiologists and intensive care physicians
Authors: Rousseau, Anne-Françoise; Thierry, Gabriel; Lambermont, Bernard; Bonhomme, Vincent; Berger-Estilita, Joana;

Prehabilitation to mitigate postintensive care syndrome in surgical patients

Abstract

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.

Country
Belgium
Keywords

Critical Illness/psychology, Anesthésie & soins intensifs, Critical Care, Postoperative Complications/prevention & control, Critical Illness, Postoperative Complications/psychology, Critical Care/methods, Preoperative Exercise, Anesthesia & intensive care, Sciences de la santé humaine, Anesthesiologists, Intensive Care Units, Postoperative Complications, Anesthesiology and Pain Medicine, Anesthesiology, Critical Illness/therapy, Physicians, postintensive care syndrome, Quality of Life, Humans, Human health sciences, Critical Illness/rehabilitation

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
Green