Greater recovery after critical illness (GRACE): a call to action to create a new roadmap for critical illness research

For decades, most critical care patients have survived hospitalisation, supporting increased attention on the long-term critical illness recovery. The term 'Post-Intensive Care Syndrome' was coined in 2012 to raise awareness of long-term impairment in physical, cognitive and/or mental health after critical illness. However, the incidence of these impairments has persisted over the past decade, reaching as high as 60% and remains a major public health problem.Aiming to set a research agenda to address evidence gaps in critical illness recovery over the next 10 years, we invited key international opinion leaders from diverse clinical and methodological backgrounds to a roundtable meeting in June 2024 to assess the progress of post-critical illness recovery research and outline a future research agenda to address the unmet needs of critical illness survivors over the next decade.An early outcome from the meeting was to conduct a thematic analysis of critical care recovery literature, which highlighted the need for effective expectation management, ongoing patient support and education throughout recovery, integration between inpatient and community care, caregiver support and opportunities to reconnect with the intensive care unit.Participants identified conceptual challenges concerning current terminology and scope, population heterogeneity and phenotyping, and outcome definitions. Methodological challenges were identified around study design, with a call to shift to contemporary trial designs, incorporating qualitative methods. Translation into clinical practice will require interdisciplinary engagement.The roundtable concluded that a roadmap should be developed to guide clinical and research efforts over the coming decade, with the aim of developing a precision recovery approach.

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Publication Details

Journal
Thorax
Published
2025-10-15
DOI
https://doi.org/10.1136/thorax-2025-223758
Citations
3
Primary Topic
Intensive Care Unit Cognitive Disorders
Type
article
Field-Weighted Citation Impact
4.64
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article

Greater recovery after critical illness (GRACE): a call to action to create a new roadmap for critical illness research

Sue Patterson, Anna‐Liisa Sutt, Kimberley Haines, Doug William Gould et al.
3 citations
Thorax
Intensive Care Unit Cognitive Disorders
4.64
article

Greater recovery after critical illness (GRACE): a call to action to create a new roadmap for critical illness research

Sue Patterson, Anna‐Liisa Sutt, Kimberley Haines, Doug William Gould, James Winearls, Arthur Kwizera, Sallyanne Duncan, Richard S Bourne, Sean M. Bagshaw, Sarah K. Andersen, Bronwen Connolly, John Francis Fraser, Carol Lynette Hodgson, Nina Leggett, Daniel Francis McAuley, Cassiano Teixeira, Joanne McPeake, Dhruv Parekh, Peter Hartley, Stephanie Parks Taylor, Dylan Flaws, Catherine L. Hough, Mary Ní Lochlainn, Jonathan Stewart, Alisa M. Higgins, Régis Goulart Rosa, Mark E. Mikkelsen, Jugdeep Dhesi, Duane Mocellin, Oystein Tronstad, Pamela MacTavish, Mary Elizabeth Wilcox, Kathy Rowan, Jill Manthorpe, Nazir Lone, Charlotte Summers, Elizabeth Wilson
article en
3 citations

Abstract

For decades, most critical care patients have survived hospitalisation, supporting increased attention on the long-term critical illness recovery. The term 'Post-Intensive Care Syndrome' was coined in 2012 to raise awareness of long-term impairment in physical, cognitive and/or mental health after critical illness. However, the incidence of these impairments has persisted over the past decade, reaching as high as 60% and remains a major public health problem.Aiming to set a research agenda to address evidence gaps in critical illness recovery over the next 10 years, we invited key international opinion leaders from diverse clinical and methodological backgrounds to a roundtable meeting in June 2024 to assess the progress of post-critical illness recovery research and outline a future research agenda to address the unmet needs of critical illness survivors over the next decade.An early outcome from the meeting was to conduct a thematic analysis of critical care recovery literature, which highlighted the need for effective expectation management, ongoing patient support and education throughout recovery, integration between inpatient and community care, caregiver support and opportunities to reconnect with the intensive care unit.Participants identified conceptual challenges concerning current terminology and scope, population heterogeneity and phenotyping, and outcome definitions. Methodological challenges were identified around study design, with a call to shift to contemporary trial designs, incorporating qualitative methods. Translation into clinical practice will require interdisciplinary engagement.The roundtable concluded that a roadmap should be developed to guide clinical and research efforts over the coming decade, with the aim of developing a precision recovery approach.

ThoraxVol. 81(1)
Queen's University Belfast (GB), Alberta Health Services (CA), Universidade Federal do Rio Grande do Sul (BR), University Hospitals Birmingham NHS Foundation Trust (GB), NHS Lothian (GB), Universidade Federal de Ciências da Saúde de Porto Alegre (BR), University of Alberta (CA), Queensland University of Technology (AU), The University of Queensland (AU), Oregon Health & Science University (US), The University of Melbourne (AU), National University of Singapore (SG), King's College London (GB), Guy's and St Thomas' NHS Foundation Trust (GB), Barts Health NHS Trust (GB), University of Cambridge (GB), University of Michigan (US), Manchester Academic Health Science Centre (GB), Gold Coast Hospital (AU), NHS Greater Glasgow and Clyde (GB), Emory University Hospital (US), Glasgow Royal Infirmary (GB), The Alfred Hospital (AU), Cambridge University Hospitals NHS Foundation Trust (GB), Edinburgh Royal Infirmary (GB), University of Manchester (GB), National Institute for Health and Care Research (GB), Hospital Moinhos de Vento (BR), Australian and New Zealand Intensive Care Society (AU), Holy Spirit Northside Private Hospital (AU), Sheffield Teaching Hospitals NHS Foundation Trust (GB), Institute for Healthcare Improvement (US), Footscray Hospital (AU), The George Institute for Global Health (AU), Brazilian Research in Intensive Care Network (BR), Western Health (AU), Monash Health (AU), Prince Charles Hospital (AU), Women and Children’s Health Research Institute (CA), St Andrew’s Hospital (AU), National University Hospital (SG), NIHR Manchester Biomedical Research Centre (GB), Intensive Care National Audit & Research Centre (GB), NIHR Birmingham Biomedical Research Centre (GB), University of Colorado Anschutz Medical Campus (US), Monash University (AU), Cabot (United States) (US), Makerere University (UG), University of Birmingham (GB), University of Colorado Denver (US), University of Edinburgh (GB)
Openalex Percentile: Top 5%
Intensive Care Unit Cognitive Disorders
4.64
DOIOpen Access PDFOpenAlex
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