Acute and critical care · 2026
Korean clinical practice guidelines for rehabilitation in critically ill patients and post-intensive care syndrome.
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Chung Chi Ryang, Yeo Hye Ju, Do Jong Geol, Na Yoonju, Choi Eunjeong, Kang Jiyeon, Kwon Jeong-Yi, Kim Hyun Jung, Park Jinyoung, Lee Hak-Jae, Jang Myung Hun, Kang Seung-Tak, Koo Kyung Hyup, Kim Young Seok, Kim Won, Kim Tae-Yoon, Park Jiyoun, Beom Jaewon, Seo Kyung Cheon, Sun Hyun-Woo, Son Woochul, Shin Myung-Jun, Ahn So Young, Lee Song I, Rhee Min-Hyung, Won Yu Hui, Yoo Myungeun, Im Yu Jin, Chang Sun Ju, Chang Ye Rim, Jeon Mi-Kyeong, Jung Jin Hee, Ha Yumi, Hyun Sung Eun, Hong Suk-Kyung, Suh Gee Young
Аннотация
BACKGROUND: Survivors of critical illness commonly experience persistent physical, cognitive, and psychological impairments, collectively known as post-intensive care syndrome. Although intensive care unit (ICU) rehabilitation is now recognized as an important part of recovery after critical illness, rehabilitation practices remain inconsistent, and clinical practice guidelines adapted to the Korean healthcare context have not been available.
METHODS: These clinical practice guidelines were developed de novo by a multidisciplinary panel comprising critical care physicians, rehabilitation specialists, nurses, and allied health professionals. The panel prioritized 15 key clinical questions addressing adult, pediatric, and neonatal ICU (NICU) rehabilitation. Systematic literature searches were conducted in Medline via PubMed, Embase, the Cochrane Library, and KoreaMed, and the final searches for all 15 questions were completed by November 30, 2024. The certainty of evidence and strength of recommendations were assessed using the Grading of Recommendations Assessment, Development and Evaluation framework. Final recommendations were approved through a structured consensus process requiring at least 70% panel agreement.
RESULTS: The panel issued 15 recommendations across major rehabilitation domains, including early structured rehabilitation, criteria for withholding or discontinuing therapy, adjunctive modalities, rehabilitation frequency, inspiratory muscle training, swallowing rehabilitation, cognitive and occupational therapy, nutritional support, neonatal and pediatric ICU rehabilitation, and post-ICU follow-up care. Thirteen recommendations were conditional, whereas two were strong, mainly because they addressed patient safety.
CONCLUSIONS: These guidelines provide evidence-informed recommendations for rehabilitation in critically ill patients across adult, pediatric, and NICUs in Korea. They are designed to standardize practice, improve patient safety, support patient-centered functional recovery beyond survival, and identify priorities for future research.
METHODS: These clinical practice guidelines were developed de novo by a multidisciplinary panel comprising critical care physicians, rehabilitation specialists, nurses, and allied health professionals. The panel prioritized 15 key clinical questions addressing adult, pediatric, and neonatal ICU (NICU) rehabilitation. Systematic literature searches were conducted in Medline via PubMed, Embase, the Cochrane Library, and KoreaMed, and the final searches for all 15 questions were completed by November 30, 2024. The certainty of evidence and strength of recommendations were assessed using the Grading of Recommendations Assessment, Development and Evaluation framework. Final recommendations were approved through a structured consensus process requiring at least 70% panel agreement.
RESULTS: The panel issued 15 recommendations across major rehabilitation domains, including early structured rehabilitation, criteria for withholding or discontinuing therapy, adjunctive modalities, rehabilitation frequency, inspiratory muscle training, swallowing rehabilitation, cognitive and occupational therapy, nutritional support, neonatal and pediatric ICU rehabilitation, and post-ICU follow-up care. Thirteen recommendations were conditional, whereas two were strong, mainly because they addressed patient safety.
CONCLUSIONS: These guidelines provide evidence-informed recommendations for rehabilitation in critically ill patients across adult, pediatric, and NICUs in Korea. They are designed to standardize practice, improve patient safety, support patient-centered functional recovery beyond survival, and identify priorities for future research.