提供标准化、对危重病人来说,高质量的康复是一个至关重要的问题。2017年,日本重症监护医学学会(JSICM)颁布了“重症监护病房早期康复循证专家共识”,以倡导在日本重症监护机构中尽早开始康复。在这项开创性工作的基础上,JSICM最近利用建议分级进行了严格的系统审查,评估,发展,和评估(等级)方法。这一努力导致了临床实践指南(CPG)的制定,旨在阐明早期ICU康复的最佳实践。本指南的主要目的是增强临床理解,从而促进基于证据的决策。最终有助于提高重症监护患者的预后。世界上以前的CPG没有专门针对危重病人的康复,使用等级方法。多学科合作在康复中极为重要。因此,CPG是由一个由工作组组成的准则发展小组的73名成员制定的,一个系统的审查小组,和一个学术指南推广小组,以JSICM为核心的重症监护早期动员和康复临床实践指南委员会。许多成员为准则的制定做出了贡献,包括具有多个和不同专业的医生和医疗保健专业人员,以及ICU患者。根据小组成员之间的讨论,确定了本CPG的8个重要临床重点领域.然后为每个领域制定了十四个重要的临床问题(CQs)。公众被邀请发表两次评论,对CQ的回答以10个GRADE建议和对四个背景问题的评论的形式提出。此外,每个CQ的信息已被创建为视觉临床流程,以确保每个CQ的定位可以很容易地理解。我们希望CPG将成为多种职业的重症患者康复的有用工具。
Providing standardized, high-quality rehabilitation for critically ill patients is a crucial issue. In 2017, the Japanese Society of Intensive Care Medicine (JSICM) promulgated the \"Evidence-Based Expert
Consensus for Early Rehabilitation in the Intensive Care Unit\" to advocate for the early initiation of rehabilitations in Japanese intensive care settings. Building upon this seminal work, JSICM has recently conducted a rigorous systematic review utilizing the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. This endeavor resulted in the formulation of Clinical Practice
Guidelines (CPGs), designed to elucidate best practices in early ICU rehabilitation. The primary objective of this guideline is to augment clinical understanding and thereby facilitate evidence-based decision-making, ultimately contributing to the enhancement of patient outcomes in critical care settings. No previous CPGs in the world has focused specifically on rehabilitation of critically ill patients, using the GRADE approach. Multidisciplinary collaboration is extremely important in rehabilitation. Thus, the CPGs were developed by 73 members of a
Guideline Development Group consisting of a working group, a systematic review group, and an academic
guideline promotion group, with the Committee for the Clinical Practice
Guidelines of Early Mobilization and Rehabilitation in Intensive Care of the JSICM at its core. Many members contributed to the development of the guideline, including physicians and healthcare professionals with multiple and diverse specialties, as well as a person who had been patients in ICU. Based on discussions among the group members, eight important clinical areas of focus for this CPG were identified. Fourteen important clinical questions (CQs) were then developed for each area. The public was invited to comment twice, and the answers to the CQs were presented in the form of 10 GRADE recommendations and commentary on the four background questions. In addition, information for each CQ has been created as a visual clinical flow to ensure that the positioning of each CQ can be easily understood. We hope that the CPGs will be a useful tool in the rehabilitation of critically ill patients for multiple professions.