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- Korean clinical practice guidelines for rehabilitation in critically ill patients and post-intensive care syndrome
- Chi Ryang Chung, Hye Ju Yeo, Jong Geol Do, Yoonju Na, Eunjeong Choi, Jiyeon Kang, Jeong-Yi Kwon, Hyun Jung Kim, Jinyoung Park, Hak-Jae Lee, Myung Hun Jang, Seung-Tak Kang, Kyung Hyup Koo, Young Seok Kim, Won Kim, Tae-Yoon Kim, Jiyoun Park, Jaewon Beom, Kyung Cheon Seo, Hyun-woo Sun, Woochul Son, Myung-Jun Shin, So Young Ahn, Song I Lee, Min-Hyung Rhee, Yu Hui Won, Myungeun Yoo, Yu Jin Im, Sun Ju Chang, Ye Rim Chang, Mi-Kyeong Jeon, Jin Hee Jung, Yumi Ha, Sung Eun Hyun, Suk-Kyung Hong, Gee Young Suh
- Acute Crit Care. 2026;41(3):439-465. Published online August 31, 2026
- DOI: https://doi.org/10.4266/acc.006630
- 3,139 View
- 166 Download
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Abstract
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Supplementary Material - Background
Survivors of critical illness commonly experience persistent physical, cognitive, and psychological impairments, collectively known as post–intensive care syndrome. Although intensive care unit (ICU) rehabilitation is now recognized as an important part of recovery after critical illness, rehabilitation practices remain inconsistent, and clinical practice guidelines adapted to the Korean healthcare context have not been available.
Methods
These clinical practice guidelines were developed de novo by a multidisciplinary panel comprising critical care physicians, rehabilitation specialists, nurses, and allied health professionals. The panel prioritized 15 key clinical questions addressing adult, pediatric, and neonatal ICU (NICU) rehabilitation. Systematic literature searches were conducted in Medline via PubMed, Embase, the Cochrane Library, and KoreaMed, and the final searches for all 15 questions were completed by November 30, 2024. The certainty of evidence and strength of recommendations were assessed using the Grading of Recommendations Assessment, Development and Evaluation framework. Final recommendations were approved through a structured consensus process requiring at least 70% panel agreement.
Results
The panel issued 15 recommendations across major rehabilitation domains, including early structured rehabilitation, criteria for withholding or discontinuing therapy, adjunctive modalities, rehabilitation frequency, inspiratory muscle training, swallowing rehabilitation, cognitive and occupational therapy, nutritional support, neonatal and pediatric ICU rehabilitation, and post-ICU follow-up care. Thirteen recommendations were conditional, whereas two were strong, mainly because they addressed patient safety.
Conclusions
These guidelines provide evidence-informed recommendations for rehabilitation in critically ill patients across adult, pediatric, and NICUs in Korea. They are designed to standardize practice, improve patient safety, support patient-centered functional recovery beyond survival, and identify priorities for future research.
Original Article
- Epidemiology
- Impact of medical crisis on the critical care system in South Korea
- Ye Rim Chang, Jae Hwa Cho, Joongbum Cho, Tae Sun Ha, Bo Gun Kho, Eunhye Kim, Im-kyung Kim, Dong Hyun Lee, Suk-Kyung Hong
- Acute Crit Care. 2025;40(3):393-401. Published online August 21, 2025
- DOI: https://doi.org/10.4266/acc.000575
- 7,498 View
- 148 Download
- 6 Web of Science
- 7 Crossref
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Abstract
PDFSupplementary Material
- Background
The ongoing medical crisis in Korea has severely impacted the operational environment of intensive care units (ICU), posing significant challenges to quality care for critically ill patients. This study aimed to evaluate the effects of the ongoing crisis on ICUs.
Methods
A survey was conducted in July 2024 among intensivists in charge of ICUs at institutions accredited by the Korean Society of Critical Care Medicine for critical care. The survey compared data from January 2024 (pre-crisis) and June 2024 (post-crisis) on the number ICU beds, staffing composition, work hours, and the number and roles of nurse practitioners.
Results
Among the total of 71 participating ICUs, 22 experienced a reduction in the number of operational beds, with a median decrease of six beds per unit, totaling 127 beds across these ICUs. The numbers of residents and interns decreased from an average of 2.3 to 0.1 per ICU, and the average weekly working hours of intensivists increased from 62.3 to 78.8 hours. Nurse practitioners helped fill staffing gaps, with their numbers rising from 150 to 242 across ICUs, and their scope of practice expanded accordingly.
Conclusions
The medical crisis has led to major changes in the critical care system, including staffing shortages, increased workloads, and an expanded role for nurse practitioners. This is a critical moment to foster interest and engage in active discussions aimed at creating a sustainable and resilient ICU system. -
Citations
Citations to this article as recorded by
- Changes in Sepsis Hospitalizations and Mortality After Junior Physicians’ Walkout in the Republic of Korea: A Nationwide Interrupted Time-Series Study
Yongseop Lee, Munjeong Choi, Jung Ho Kim, Jaehoon Kim, Min Han, Jung Ah Lee, Jin Young Ahn, Su Jin Jeong, Nam Su Ku, Joon-Sup Yeom, Sung-In Jang, Jun Yong Choi
Journal of Korean Medical Science.2027;[Epub] CrossRef - Resident Physician Walkout and High-Incidence Cancer Operation Volumes in South Korea
Chanseok Son, Jaehun Jung, Hyejin Joo
JAMA Network Open.2026; 9(3): e260697. CrossRef - Changes in American Society of Anesthesiologists Physical Status Distribution and Prognostic Performance During the 2024 South Korean Healthcare Crisis: A Large-Scale Retrospective Cohort Study
Chan-Sik Kim, Sang-Wook Lee
Journal of Clinical Medicine.2026; 15(11): 4261. CrossRef - Changes in Patient Characteristics and Early Clinical Outcomes Among Emergency Department–Admitted Inpatients During the 2024 Medical Workforce Crisis in South Korea
Yeon Joo Lee, Sung Woo Moon
Journal of Clinical Medicine.2026; 15(12): 4804. CrossRef - Changes in Health Care Utilization and Costs During the 2024 Medical Strike in Korea: Evidence From a Specialty-Level Analysis
Hyangmi Kim, Joon Young Kim
Asia Pacific Journal of Public Health.2026; 38(6-7): 491. CrossRef - In-Hospital Cardiac Resuscitation During Widespread Resident Resignations in South Korea
Donghyeong Koo, Sulhee Kim, Hyun-Jun Park, Yoon Hae Ahn, Kyung-Eui Lee, Si Mong Yoon, Choon Geun Lee, Hong Yeul Lee, Joo Hae Kim, Sang-Min Lee, Jinwoo Lee
JAMA Network Open.2026; 9(9): e2635568. CrossRef - From trauma surgery to acute care surgery: a 4-year observational study at a single trauma center in Korea
Jung-Woo Woo, Jae Yool Jang, Yo Seok Cho, Hongkyung Shin, Chan Yong Park
Journal of Trauma and Injury.2025; 38(4): 382. CrossRef
- Changes in Sepsis Hospitalizations and Mortality After Junior Physicians’ Walkout in the Republic of Korea: A Nationwide Interrupted Time-Series Study
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