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Invited Commentary
June 2015

Improving Functional Recovery After Critical Illness

Author Affiliations
  • 1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Duke University, Durham, North Carolina
  • 2Program to Support People and Enhance Recovery, Duke University, Durham, North Carolina
  • 3Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Washington, Seattle
JAMA Intern Med. 2015;175(6):911-912. doi:10.1001/jamainternmed.2015.0829

Conducting clinical research among critically ill patients is a tough business. Few disciplines have experienced such difficulty aligning positive physiologic studies with survival and the other outcomes that matter most to families: functional independence and quality of life. This trend continues with the publication in this issue of JAMA Internal Medicine of the article by Walsh and colleagues1 of the RECOVER study. In this well-conducted randomized clinical trial (RCT) involving 2 Scottish hospitals, a multicomponent post–intensive care unit (ICU) discharge rehabilitation intervention conveyed no advantage compared with usual care in mobility, quality of life, psychological distress, or symptoms measured at the 3- and 12-month follow-ups. This study finds its place among 3 prior RCTs of rehabilitation interventions beginning at discharge from the ICU or the hospital that similarly failed to improve key outcomes.24

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