Japanese Clinical Practice Guidelines for Rehabilitation in Critically Ill Patients 2023 (J-ReCIP 2023)
Authors: Unoki Takeshi , Hayashida Kei , Kawai Yusuke , Taito Shunsuke , Ando Morihide , Iida Yuki , Kasai Fumihito , Kawasaki Tatsuya , Kozu Ryo , Kondo Yutaka , Saitoh Masakazu , Sakuramoto Hideaki , Sasaki Nobuyuki , Saura Ryuichi , Nakamura Kensuke , Ouchi Akira , Okamoto Saiko , Okamura Masatsugu , Kuribara Tomoki , Kuriyama Akira , Matsuishi Yujiro , Yamamoto Norimasa , Yoshihiro Shodai , Yasaka Taisuke , Abe Ryo , Iitsuka Takahito , Inoue Hiroyasu , Uchiyama Yuki , Endo Satoshi , Okura Kazuki , Ota Kohei , Otsuka Takahisa , Okada Daisuke , Obata Kengo , Katayama Yukiko , Kaneda Naoki , Kitayama Mio , Kina Shunsuke , Kusaba Ryuichi , Kuwabara Masanari , Sasanuma Naoki , Takahashi Masahiro , Takayama Chihiro , Tashiro Naonori , Tatsuno Junko , Tamura Takahiko , Tamoto Mitsuhiro , Tsuchiya Asuka , Tsutsumi Yusuke , Nagato Tadashi , Narita Chihiro , Nawa Tomohiro , Nonoyama Tadayoshi , Hanada Masatoshi , Hirakawa Kotaro , Makino Akiko , Masaki Hirotaka , Matsuki Ryosuke , Matsushima Shinya , Matsuda Wataru , Miyagishima Saori , Moromizato Masaru , Yanagi Naoya , Yamauchi Kota , Yamashita Yuhei , Yamamoto Natsuhiro , Liu Keibun , Wakabayashi Yuki , Watanabe Shinichi , Yonekura Hiroshi , Nakanishi Nobuto , Takahashi Tetsuya , Nishida Osamu ,   The Committee for the Clinical Practice Guidelines of Early Mobilization and Rehabilitation in Intensive Care of the Japanese Society of Intensive Care Medicine
Published: November 2023

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.

Graphical Abstract