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Review
. 2023 Nov 7;11(1):47.
doi: 10.1186/s40560-023-00697-w.

Japanese Clinical Practice Guidelines for Rehabilitation in Critically Ill Patients 2023 (J-ReCIP 2023)

Takeshi Unoki  1 , Kei Hayashida  2 , Yusuke Kawai  3 , Shunsuke Taito  4 , Morihide Ando  5 , Yuki Iida  6 , Fumihito Kasai  7 , Tatsuya Kawasaki  8 , Ryo Kozu  9   10 , Yutaka Kondo  11 , Masakazu Saitoh  12 , Hideaki Sakuramoto  13 , Nobuyuki Sasaki  14 , Ryuichi Saura  15 , Kensuke Nakamura  16 , Akira Ouchi  17 , Saiko Okamoto  18 , Masatsugu Okamura  19 , Tomoki Kuribara  20 , Akira Kuriyama  21 , Yujiro Matsuishi  22 , Norimasa Yamamoto  23 , Shodai Yoshihiro  24 , Taisuke Yasaka  25 , Ryo Abe  26 , Takahito Iitsuka  27 , Hiroyasu Inoue  28 , Yuki Uchiyama  29 , Satoshi Endo  30 , Kazuki Okura  31 , Kohei Ota  32 , Takahisa Otsuka  33 , Daisuke Okada  34 , Kengo Obata  35 , Yukiko Katayama  36 , Naoki Kaneda  37 , Mio Kitayama  38 , Shunsuke Kina  39 , Ryuichi Kusaba  40 , Masanari Kuwabara  41 , Naoki Sasanuma  42 , Masahiro Takahashi  43 , Chihiro Takayama  44 , Naonori Tashiro  45 , Junko Tatsuno  46 , Takahiko Tamura  47 , Mitsuhiro Tamoto  48 , Asuka Tsuchiya  49 , Yusuke Tsutsumi  50 , Tadashi Nagato  51 , Chihiro Narita  52 , Tomohiro Nawa  53 , Tadayoshi Nonoyama  54 , Masatoshi Hanada  9 , Kotaro Hirakawa  55 , Akiko Makino  22 , Hirotaka Masaki  56 , Ryosuke Matsuki  57 , Shinya Matsushima  58 , Wataru Matsuda  59 , Saori Miyagishima  60 , Masaru Moromizato  61 , Naoya Yanagi  62 , Kota Yamauchi  63 , Yuhei Yamashita  64 , Natsuhiro Yamamoto  65 , Keibun Liu  66   67   68 , Yuki Wakabayashi  69 , Shinichi Watanabe  70 , Hiroshi Yonekura  71 , Nobuto Nakanishi  72 , Tetsuya Takahashi  12 , Osamu Nishida  73 ; Committee for the Clinical Practice Guidelines of Early Mobilization and Rehabilitation in Intensive Care of the Japanese Society of Intensive Care Medicine
Affiliations
Review

Japanese Clinical Practice Guidelines for Rehabilitation in Critically Ill Patients 2023 (J-ReCIP 2023)

Takeshi Unoki et al. J Intensive Care. .

Abstract

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.

Keywords: Critically ill patient; Early rehabilitation; Guidelines; Intensive care.

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Conflict of interest statement

All committee members and working group members submitted disclosure forms of financial and academic conflict of interest (COI) prior to being requested to participate in individual activities. Declarations regarding conflicts of interest (COI) were made in accordance with the COI Management Guidelines of the Japanese Association of Medical Sciences, and COIs were confirmed by a group independent of the committee. Detailed information of COI and the roles in creating this guideline are summarized in Additional file 1.

Figures

Fig. 1
Fig. 1
Clinical flow of the clinical practice guidelines
Fig. 2
Fig. 2
Graphical abstract of the clinical practice guidelines
See this image and copyright information in PMC

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