Skip to main content
Download PDF

Resilience after severe critical illness: a prospective, multicentre, observational study (RESIREA)

Critical Care volume 28, Article number: 237 (2024) Cite this article

Abstract

Background

Critical-illness survivors may experience post-traumatic stress disorder (PTSD) and quality-of-life impairments. Resilience may protect against psychological trauma but has not been adequately studied after critical illness. We assessed resilience and its associations with PTSD and quality of life, and also identified factors associated with greater resilience.

Methods

This prospective, multicentre, study in patients recruited at 41 French ICUs was done in parallel with the NUTRIREA-3 trial in patients given mechanical ventilation and vasoactive amines for shock. Three months to one year after intensive-care-unit admission, survivors completed the Connor-Davidson Resilience Scale (CD-RISC-25), Impact of Event-Revised scale for PTSD symptoms (IES-R), SF-36 quality-of-life scale, Multidimensional Scale of Perceived Social Support (MSPSS), and Brief Illness Perception Questionnaire (B-IPQ).

Results

Of the 382 included patients, 203 (53.1%) had normal or high resilience (CD-RISC-25 ≥ 68). Of these resilient patients, 26 (12.8%) had moderate to severe PTSD symptoms (IES-R ≥ 24) vs. 45 (25.4%) patients with low resilience (p = 0.002). Resilient patients had higher SF-36 scores. Factors independently associated with higher CD-RISC-25 scores were higher MSPSS score indicating stronger social support (OR, 1.027; 95%CI 1.008–1.047; p = 0.005) and lower B-IPQ scores indicating a more threatening perception of the illness (OR, 0.973; 95%CI 0.950–0.996; p = 0.02).

Conclusions

Resilient patients had a lower prevalence of PTSD symptoms and higher quality of life scores, compared to patients with low resilience. Higher scores for social support and illness perception were independently associated with greater resilience. Thus, our findings suggest that interventions to strengthen social support and improve illness perception may help to improve resilience. Such interventions should be evaluated in trials with PTSD mitigation and quality-of-life improvement as the target outcomes.

Background

With advances in intensive care medicine and increasing numbers of patients admitted to intensive care units (ICUs), the number of critical-illness survivors is growing steadily. Studies have shown that these patients are at high risk for physical, cognitive, and psychological impairments that may persist for months or years. One of the main adverse psychological effects of critical illness is post-traumatic stress disorder (PTSD), which affects 4–62% of patients [1,2,3,4]. Clinical symptoms of PTSD include intrusive thoughts and memories of the traumatic event, avoidance of reminders of the event, and hyperarousal symptoms such as irritability, impaired concentration, and hypervigilance [5]. These symptoms can persist for over five years after ICU discharge and are associated with impaired quality of life [6].

Psychological resilience is the ability to adapt positively to traumatic and stressful events, thereby protecting against mental ill-health [7]. Resilient people are more likely to develop effective coping strategies for handling adverse situations [8]. Studies in patients with cancer have shown that greater resilience was associated with less anxiety and depression [9, 10]. Resilience can change throughout life and is influenced by both external factors, such as social support, and internal factors, such as perception of the illness and treatment [11,12,13,14,15].

Although the psychological burden of critical illness has been extensively investigated in ICU survivors and their relatives, few studies have focussed on patient resilience. Among patients having survived critical illness or trauma, the proportion with normal-to-high resilience varied widely, from 28 to 76%, and greater resilience was associated with less mental ill-health, pain, physical complaints, and self-care difficulties [16]. These data raise the possibility that promoting resilience in critical-illness survivors may improve psychological and quality-of-life outcomes [17]. However, only a few small studies have assessed the prevalence and determinants of resilience in this population, and they varied regarding the tools used to measure resilience [18].

The primary objective of the prospective, multicentre, observational RESIREA cohort study reported here was to assess resilience in a large cohort of survivors of severe critical illness, using the well-validated 25-item Connor-Davidson Resilience Scale (CD-RISC-25). The secondary objectives were to assess potential associations linking resilience to PTSD symptoms and quality of life and to identify factors associated with the level of resilience.

Methods

Study design and oversight

RESIREA was a planned study conducted in parallel with the randomised controlled multicentre open-label NUTRIREA-3 trial designed to evaluate whether low-calorie low-protein feeding decreased day-90 mortality and/or time to ICU discharge readiness, compared to standard calorie-protein supplies, in adults receiving invasive mechanical ventilation and vasopressor support for shock (ClinicalTrials.gov Identifier: NCT03573739) [19, 20]. The NUTRIREA-3 study was supported by the Nantes University Hospital and funded by a 2017 Programme Hospitalier de Recherche Clinique National grant from the French Ministry of Health (#PHRC-17-0213). NUTRIREA-3 was approved by the competent ethics committee (Comité de Protection des Personnes Sud-Méditerranée 2, #2018-A00424-51).

RESIREA was a multicentre, prospective, observational, cohort study. Of the 61 ICUs participating in the NUTRIREA-3 trial, 41 accepted to also participate in the RESIREA study, including 22 (53.7%) in university hospitals (Additional File 1: RESIREA sites and contributors). Because of organisational constraints, the RESIREA start date was not the same in all 41 ICUs. However, in all ICUs, inclusions in RESIREA stopped at inclusion of the last NUTRIREA-3 trial patient. The RESIREA patients were interviewed by psychologists, who administered five pre-specified questionnaires. The RESIREA study was supported by the Nantes University Hospital. The RESIREA study protocol was approved by the ethics committee of the French Intensive Care Society (CE SRLF 18–19).

Participants

Inclusion in the study occurred in two steps. First, in each participating ICU, consecutive patients included in NUTRIREA-3 were considered for inclusion in RESIREA. Inclusion and exclusion criteria were similar to those for NUTRIREA-3: adults (18 years or older) were eligible if they were receiving invasive mechanical ventilation, with an expected duration of at least 48 h after inclusion and initiation either within 24 h after or within 24 h before ICU admission, concomitantly with vasoactive therapy for shock, and if nutritional support was expected to be started within 24 h after intubation (or within 24 h after ICU admission when intubation occurred before ICU admission). Non-inclusion criteria were specific nutritional needs, such as pre-existing long-term home enteral or parenteral nutrition for chronic bowel disease; dying patient, not-to-be-resuscitated order, or other treatment-limitation decision at ICU admission; pregnancy, recent delivery, or lactation; adult under guardianship; and correctional facility inmate. Specific informed consent for inclusion in the RESIREA study was obtained from the patients, or from their next of kin in patients unable to consent. In the second step, which occurred at ICU discharge, the following non-inclusion criteria were applied: death in the ICU, insufficient fluency in French, persistent severe illness or severe cognitive impairment precluding questionnaire completion, and consent withdrawal.

Data collection

The baseline features of each patient were recorded at inclusion in the NUTRIREA-3 trial. Infectious and non-infectious complications during the ICU stay, dialysis in the ICU, duration of invasive mechanical ventilation, ICU and hospital lengths of stay, and mortality were recorded according to the NUTRIREA-3 trial protocol [19, 20].

Marital status, employment status, number of children, and history of psychiatric disorders were obtained during phone interviews by trained psychologists who had no knowledge of the medical data of the patients. Each interview involved the administration of five scales and lasted about 40 min. The phone numbers used were those in the ICU medical files for each patient. When a call was unanswered, at least two further attempts were made during different days or weeks. Two interviews were planned initially, three months and one year after inclusion in NUTRIREA-3 and RESIREA. However, organisational issues and difficulties experienced by some patients with participating in two long interviews prompted us to aim for at least one interview in each patient. When two interviews were performed, the data obtained during the most recent interview were used for the main analysis. Thus, in all patients, data from a single interview were analysed.

Outcomes

Resilience was assessed with the CD-RISC-25 [21]. Each item is answered using a 0–4 Likert scale. The total score can range from 0 to 100, with higher scores indicating greater resilience. The items are grouped into five sub-scales: personal competence, high standards, and tenacity (eight items; sub-score range, 0–32), trust in one’s instincts, tolerance of negative affect, and strengthening effects of stress (seven items; sub-score range, 0–28), positive acceptance of change and secure relationships (five items; sub-score range, 0–20), control (three items; sub-score range, 0–12), and spiritual influences (two items; sub-score range, 0–8). We defined low, normal, and high resilience as CD-RISC-25 scores ≤ 67, 68–92, and ≥ 93, respectively [21, 22]. Patients designated as “resilient” hereafter are those with scores ≥ 68; patients with scores below this cut-off are designated “non-resilient”.

PTSD symptoms were assessed with the Impact of Event Scale-Revised (IES-R). The symptoms are grouped into three sub-scores: intrusion (sub-score range, 0–32), avoidance (sub-score range, 0–32), and hyperarousal (sub-score range, 0–24). The total score can range from 0 to 88, with higher scores indicating greater symptom severity. We defined severe, moderate, and no PTSD symptoms as IES-R scores ≥ 33, 24–32, and ≤ 23, respectively [23, 24].

Health-related quality of life was assessed with the Short Form-36 (SF-36) [25, 26]. The 36 items investigate eight dimensions: bodily pain, general health, mental health, physical functioning, role emotional, role physical, vitality, and social functioning. Eight sub-scores can be calculated, each of them contributing in different proportions to the calculation of two scores (PCS: physical component summary and MCS: mental component summary), each ranging from 0 to 100. Higher PCS and MCS scores indicate better health-related quality of life.

Social support was assessed with the Multidimensional Scale of Perceived Social Support (MSPSS), a 12-item questionnaire measuring the perceived adequacy of social support received from three sources: family, friends, and significant other persons. Each item is rated on a 7-point Likert scale (from 1, strongly disagree to 7, very strongly agree). The total score can range from 12 to 84 and each sub-score from 4 to 28. Higher values indicate greater social support [27].

Perception of illness by the patients was assessed with the Brief Illness Perception Questionnaire (B-IPQ). A 0–10 scale is used to rate eight of the nine B-IPQ items including five items for the cognitive illness representation sub-score (perceived consequences, perception of the timeline, amount of perceived personal control, amount of control of the treatment, and identity; range, 0–50), two items for the emotional illness representation sub-score (concern about the illness and emotional response to the illness; range, 0–20), and one item for the illness comprehensibility sub-score (understanding of the illness; range, 0–10). An additional item assesses causal perceptions by asking patients to list the three most likely causes for their illness. The total B-IPQ score is the sum of the scores on the first eight items and can thus range from 0 to 80, with higher scores reflecting a more threatening perception of the illness [28].

Perceived social support and perception of illness were assessed as dimensions possibly contributing to resilience after critical illness.

Statistical analysis

No reliable data were available for anticipating the difference between groups. Given the observational design, we planned to perform adjusted analyses and, therefore, required sufficient observations for the large number of covariates (about 40 continuous and 10 qualitative covariates). We consequently planned to recruit 400 survivors of severe critical illness.

Baseline characteristics were described as number and percentage for qualitative variables and as mean ± SD and median [interquartile range] for quantitative variables.

For the five questionnaires, responses to at least 75% of items was required for inclusion in the analysis. Mean imputation was performed for missing data.

We determined the percentage of resilient patients (CD-RISC-25 score > 68), with the 95% confidence interval (95%CI). We also determined the percentage of patients with PTSD symptoms, overall and in each severity category (≥ 33 and 24–32), with the 95%CIs. The correlation between the IES-R and CD-RISC-25 scores was assessed by estimating the Spearman correlation coefficient, its 95%CI, and the associated p value. The SF-36, MSPSS, and B-IPQ scores were compared in resilient vs. non-resilient patients by applying the Wilcoxon test.

To identify factors associated with resilience, we first performed univariate analyses using the chi-square or Fisher test for qualitative variables and the Wilcoxon test for quantitative variables. Logistic regression was then used for the multivariate analysis. Variables with significant differences by univariate analysis (p < 0.20) were included in the multivariate analysis.

The analyses were performed using SAS version 9.4 (SAS Institute, Cary, NC) and R version 3.3.1 (htpps://www.r-project.org).

Results

Patients

Figure 1 is the patient flow chart. From 23 October 2018 to 8 December 2020, 1581 patients in the 41 participating ICUs were screened for eligibility; among them, 1026 had exclusion criteria, leaving 555 patients eligible for the RESIREA study. Of these, 173 were not interviewed. The remaining 382 (68.8%) patients were included in the analysis (Additional File 2, Table S1). Patients included in the analysis did not differ from patients who were eligible but could not be interviewed (Table 1).

Fig. 1
figure 1

Flow chart. ICU: intensive care unit

Full size image
Table 1 Comparison of the main baseline characteristics between patients included in the analysis and patients who were eligible for inclusion but were not interviewed
Full size table

Resilience, post-traumatic stress disorder symptoms, and quality of life

The median CD-RISC-25 was 69.0 [59.0–78.0]) (Table 2). Of the 382 patients, 203 (53.1%) were resilient, i.e., had CD-RISC-25 scores ≥ 68.

Table 2 Resilience in the 382 included patients discharged alive from the intensive care unit
Full size table

The median total IES-R score was 9.0 [4.0–19.0]) (Table 3). The total score and each of the three sub-scores were significantly lower in resilient than in non-resilient patients. The IES-R score decreased as the CD-RISC-25 score increased (r, − 0.24; 95%CI [− 0.33 to − 0.14]; p < 0.0001; Additional File 3, Figure S1). Comparisons of CD-RISC-25 and IES-R scores obtained at 3 months vs. 12 months revealed no significant differences in the prevalence of resilient patients or in the prevalence of patients with PTSD (Additional File 4, Table S2).The median SF-36 PCS and MCS scores were 43.0 [34.0–51.0]) and 51.0 [40.0–57.0], respectively (Table 4). The MCS, PCS and seven of the eight sub-scores (the exception being role physical) were higher in resilient patients, indicating better quality of life compared to non-resilient patients.

Table 3 Post-traumatic stress disorder symptoms and quality of life in the 382 included patients discharged alive from the intensive care unit
Full size table
Table 4 Social support and illness perception in the 382 included patients discharged alive from the intensive care unit
Full size table

Factors associated with resilience

The median MSPSS and B-IPQ scores were 75.0 [63.0–83.0] and 37.0 [26.0–45.0], respectively (Table 4). Resilient patients had higher MSPSS score and sub-scores, indicating stronger perceived social support, and lower B-IPQ score and sub-scores, indicating more favourable perceptions of their illness, compared to non-resilient patients. By univariate analysis, resilient and non-resilient patients did not differ regarding baseline characteristics or ICU outcomes (Table 5). Both stronger perceived social support and a more favourable perception of illness were independently associated with resilience (MPSS: OR, 1.027; 95%CI 1.008–1.047; p = 0.005; B-IPQ: OR, 0.973; 95%CI 0.950–0.996; p = 0.02) (Additional File 5, Table S3).

Table 5 Univariate analysis of demographic characteristics in resilient and non-resilient patients
Full size table

Discussion

In this large prospective study, half the survivors of severe critical illness had normal to high resilience. These resilient patients were less affected by PTSD symptoms and had higher health-related quality of life scores than did non-resilient patients. Resilience was associated neither with the characteristics of the acute illness nor with sex, age, or any other baseline variables. In contrast, stronger perceived social support and a more favourable perception of the illness were independently associated with resilience. Although causal interferences cannot strongly be assessed with our study design, these findings suggest interventions for increasing resilience with the goal of decreasing trauma-induced adverse responses and for improving quality of life in survivors of critical illness.

Critical illness is a traumatic event that can be followed by PTSD symptoms and quality-of-life impairments. Previous studies in non-critically ill patients have shown that interventions to improve resilience shortly after trauma exposure or in patients with PTSD may be useful to limit PTSD symptoms and improve quality of life [12]. A pilot randomised clinical trial showed that a brief six-session resilience-building programme started just before ICU discharge in survivors of critical neurological injury was feasible and associated with reduced symptoms of anxiety, depression, and PTSD three months later compared to minimally enhanced standard care in the patients and their informal caregivers [17]. This finding is important, as it supports the ability of resilience-building to prevent subsequent mental distress. The median IES-R score and proportion of patients with PTSD symptoms in our cohort are in agreement with earlier reports [1]. Importantly, PTSD symptoms were twice as common in the non-resilient group as in the resilient group, in keeping with a study in trauma patients [16]. Resilient patients also had higher quality of life scores as compared to non-resilient patients. Moreover, given that 47% of patients had low resilience, these findings suggest that improving resilience may be associated with a reduction in PTSD and improved quality of life in survivors of critical illness.

Resilience was not associated neither with the characteristics of the acute illness nor with the baseline features of the patients. This finding is consistent with a previous study in trauma patients [16]. In contrast the independent associations with social support and illness perception suggest avenues for intervention. The effect size seems small in our study, but others have also reported associations linking mental health, social support and resilience [16, 31]. Moreover perception of illness was associated with psychological well-being and improved coping [32,33,34]. A highly positive perception of illness was associated with greater treatment adherence and improved recovery and mental health [35, 36]. Illness perception is probably amenable to modification via psychological support [37]. Programmes have been developed in settings other than critical illness to increase the perception of control over the disease [38]. In a randomised controlled trial in patients with heart failure, an educational programme was effective in improving illness perception and was also associated with better results on measures of quality of life and self-care [39]. Improving illness perception resulted in better outcomes of patients with chronic low back pain in another randomised controlled trial [40]. Illness perception seems readily amenable to change via simple interventions, which thus deserve to be investigated in survivors of critical illness [41]. In the ICU, research is needed to determine whether assessing illness perception may help intensivists to apply communication techniques likely to improve their patients’ understanding of their illness and experience in the ICU. Finally, our study suggests that interventions focused on promoting resilience may be more effective than targeting specific disorders in ICU survivors. Qualitative studies showed that patients experienced difficulties in accessing the appropriate care for post-ICU syndrome, obtaining information about their post-resuscitation symptoms, and understanding what they had experienced in the ICU [42, 43]. Our study showing high levels of PTSD symptoms supports the development of post-ICU follow-up visits and the routine provision of psychologist support after ICU discharge. Assessment of social support and illness perception may allow multidisciplinary interventions aimed at improving resilience, thereby alleviating PTSD symptoms and improving quality of life [44].

Our study has several limitations. First, that 31% of patients eligible for the study could not be interviewed may have introduced selection bias. However, we evidenced no significant differences between these patients and those who were interviewed. Moreover, to our knowledge, RESIREA is the largest study to date of resilience after critical illness. Second, logistical issues prevented us from performing two interviews, three months and one year after ICU discharge, in all patients. Also, we had no data on resilience or PTSD symptoms before the critical illness. We were consequently unable to assess possible changes in these two variables over time in individual patients. However, data collected at 3 and at 12 months did not differ significantly regarding the proportions of resilient patients or of patients with PTSD symptoms. These findings align with a scoping review showing no clinically significant changes in mental-health symptoms over the first year after ICU discharge, also with no pre-illness data [18]. Using both 3-month and 12-month data in our study was therefore legitimate and cannot have affected the results, their interpretation, or our conclusion. Importantly, the 53.1% proportion of resilient patients was within the previously reported range (28–67%) in critical-care settings [18]. Third, all 41 participating ICUs were in France. This may limit the general applicability of our findings. Nonetheless, the strengths of our study include the prospective design, multicentre recruitment providing a large sample size, and use of the CD-RISC-25 to assess resilience. This tool has well-validated psychometric properties [18, 21]. Also, the data were collected by psychologists trained in telephone interviewing and in administration of the five questionnaires used for the study. Questionnaires data were missing for less than 2% of patients. These facts support the reliability and general applicability of our data. Fourth, the observational design of the study precludes definitive conclusions about causal relationships between resilience and PTSD in our cohort. Measurements at baseline then repeatedly during follow-up would be ideal to assess causality. Nonetheless, our findings generate strong hypotheses for designing interventional trials aimed at enhancing resilience and thereby possibly mitigating PTSD and improving quality of life. Last, we focussed on patients who survived an episode of severe critical illness requiring at least invasive mechanical ventilation and vasoactive drugs. We thus studied a uniform population of patients at high risk for long-term mental-health disturbances and, therefore, likely to benefit the most from strategies designed to improve resilience.

Conclusions

Among survivors of severe critical illness, those with normal or high resilience were less affected by PTSD symptoms and had higher health-related quality-of-life scores. Greater resilience was independently associated with stronger social support and a more favourable perception of the illness but not with the characteristics of the acute illness or the baseline variables. Attention to social support and illness perception may help to strengthen resilience with the goal of improving the psychological outcomes of ICU survivors. `

Availability of data and materials

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Abbreviations

PTSD:

Post-traumatic stress disorder

ICU:

Intensive Care Unit

CD-RISC-25:

Connor-Davidson Resilience Scale

IES-R:

Impact of Event-Revised scale

SF-36:

Short Form-36

PCS:

Physical component summary

MCS:

Mental component summary

MSPSS:

Multidimensional Scale of Perceived Social Support

B-IPQ:

Brief Illness Perception Questionnaire

References

  1. Parker AM, Sricharoenchai T, Raparla S, Schneck KW, Bienvenu OJ, Needham DM. Posttraumatic stress disorder in critical illness survivors: a metaanalysis*. Crit Care Med. 2015;43(5):1121–9.

    Article  PubMed  Google Scholar 

  2. Boer KR, Mahler CW, Unlu C, Lamme B, Vroom MB, Sprangers MA, et al. Long-term prevalence of post-traumatic stress disorder symptoms in patients after secondary peritonitis. Crit Care. 2007;11(1):R30.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Cuthbertson BH, Hull A, Strachan M, Scott J. Post-traumatic stress disorder after critical illness requiring general intensive care. Intensiv Care Med. 2004;30(3):450–5.

    Article  Google Scholar 

  4. Svenningsen H, Langhorn L, Ågård AS, Dreyer P. Post-ICU symptoms, consequences, and follow-up: an integrative review: review post-ICU. Nurs Crit Care. 2017;22(4):212–20.

    Article  PubMed  Google Scholar 

  5. Yehuda R. 011002 Post-Traumatic Stress Disorder. N Engl J Med.

  6. Bienvenu OJ, Friedman LA, Colantuoni E, Dinglas VD, Sepulveda KA, Mendez-Tellez P, et al. Psychiatric symptoms after acute respiratory distress syndrome: a 5-year longitudinal study. Intensiv Care Med. 2018;44(1):38–47.

    Article  Google Scholar 

  7. Southwick SM, Bonanno GA, Masten AS, Panter-Brick C, Yehuda R. Resilience definitions, theory, and challenges: interdisciplinary perspectives. Eur J Psychotraumatol. 2014;5(1):25338.

    Article  Google Scholar 

  8. Mayordomo T, Viguer P, Sales A, Satorres E, Meléndez JC. Resilience and coping as predictors of well-being in adults. J Psychol. 2016;150(7):809–21.

    Article  PubMed  Google Scholar 

  9. Ye ZJ, Qiu HZ, Li PF, Liang MZ, Zhu YF, Zeng Z, et al. Predicting changes in quality of life and emotional distress in Chinese patients with lung, gastric, and colon-rectal cancer diagnoses: the role of psychological resilience: predicting changes in emotional distress and quality of life. Psychooncology. 2017;26(6):829–35.

    Article  PubMed  Google Scholar 

  10. Ye ZJ, Liang MZ, Qiu HZ, Liu ML, Hu GY, Zhu YF, et al. Effect of a multidiscipline mentor-based program, Be Resilient to Breast Cancer (BRBC), on female breast cancer survivors in mainland China—a randomized, controlled, theoretically-derived intervention trial. Breast Cancer Res Treat. 2016;158(3):509–22.

    Article  PubMed  Google Scholar 

  11. Sihvola S, Kuosmanen L, Kvist T. Resilience and related factors in colorectal cancer patients: a systematic review. Eur J Oncol Nurs. 2022;56: 102079.

    Article  PubMed  Google Scholar 

  12. Horn SR, Charney DS, Feder A. Understanding resilience: new approaches for preventing and treating PTSD. Exp Neurol. 2016;284:119–32.

    Article  CAS  PubMed  Google Scholar 

  13. Macía P, Barranco M, Gorbeña S, Iraurgi I. Expression of resilience, coping and quality of life in people with cancer. Frey R, editor. PLoS ONE. 2020;15(7):e0236572.

  14. Chiu HC, Lin CY, Kuo YL, Hou WL, Shu BC. Resilience among women with breast cancer surviving longer than five years: the relationship with illness perception and body image. Eur J Oncol Nurs. 2023;62: 102254.

    Article  PubMed  Google Scholar 

  15. Stewart DE, Yuen T. A systematic review of resilience in the physically Ill. Psychosomatics. 2011;52(3):199–209.

    Article  PubMed  Google Scholar 

  16. Nehra D, Herrera-Escobar JP, Al Rafai SS, Havens J, Askari R, Nitzschke S, et al. Resilience and long-term outcomes after trauma: an opportunity for early intervention? J Trauma Acute Care Surg. 2019;87(4):782–9.

    Article  PubMed  Google Scholar 

  17. Vranceanu AM, Bannon S, Mace R, Lester E, Meyers E, Gates M, et al. Feasibility and efficacy of a resiliency intervention for the prevention of chronic emotional distress among survivor-caregiver dyads admitted to the neuroscience intensive care unit: a randomized clinical trial. JAMA Netw Open. 2020;3(10): e2020807.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Pauley E, Walsh TS. Resilience in survivors of critical illness: a scoping review of the published literature in relation to definitions, prevalence, and relationship to clinical outcomes. J Intensiv Care Soc. 2022;23(3):345–58.

    Article  Google Scholar 

  19. Reignier J, Le Gouge A, Lascarrou JB, Annane D, Argaud L, Hourmant Y, et al. Impact of early low-calorie low-protein versus standard-calorie standard-protein feeding on outcomes of ventilated adults with shock: design and conduct of a randomised, controlled, multicentre, open-label, parallel-group trial (NUTRIREA-3). BMJ Open. 2021;11(5):e045041.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Reignier J, Plantefeve G, Mira JP, Argaud L, Asfar P, Aissaoui N, et al. Low versus standard calorie and protein feeding in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel-group trial (NUTRIREA-3). Lancet Respir Med. 2023;S2213260023000929.

  21. Connor KM, Davidson JRT. Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety. 2003;18(2):76–82.

    Article  PubMed  Google Scholar 

  22. Maley JH, Brewster I, Mayoral I, Siruckova R, Adams S, McGraw KA, et al. Resilience in survivors of critical illness in the context of the survivors’ experience and recovery. Ann Am Thorac Soc. 2016;13(8):1351–60.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Rash CJ, Coffey SF, Baschnagel JS, Drobes DJ, Saladin ME. Psychometric properties of the IES-R in traumatized substance dependent individuals with and without PTSD. Addict Behav. 2008;33(8):1039–47.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Creamer M, Bell R, Failla S. Psychometric properties of the impact of event scale—revised. Behav Res Ther. 2003;41(12):1489–96.

    Article  PubMed  Google Scholar 

  25. Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473–83.

    Article  PubMed  Google Scholar 

  26. Chrispin PS, Scotton H, Rogers J, Lloyd D, Ridley SA. Short Form 36 in the intensive care unit: assessment of acceptability, reliability and validity of the questionnaire. Anaesthesia. 1997;52(1):15–23.

    Article  CAS  PubMed  Google Scholar 

  27. Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. J Pers Assess. 1988;52(1):30–41.

    Article  Google Scholar 

  28. Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. J Psychosom Res. 2006;60(6):631–7.

    Article  PubMed  Google Scholar 

  29. Le Gall JR. A new simplified acute physiology score (SAPS II) based on a European/North American multicenter study. JAMA. 1993;270(24):2957.

    Article  PubMed  Google Scholar 

  30. Vincent JL, Moreno R, Takala J, Willatts S, De Mendonca A, Bruining H, et al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensiv Care Med. 1996;22(7):707–10.

    Article  CAS  Google Scholar 

  31. Eakman AM, Schelly C, Henry KL. Protective and vulnerability factors contributing to resilience in post-9/11 veterans with service-related injuries in postsecondary education. Am J Occup Ther. 2016;70(1):7001260010p1–10.

  32. Leventhal H, Diefenbach M, Leventhal EA. Illness cognition: using common sense to understand treatment adherence and affect cognition interactions. Cogn Ther Res. 1992;16(2):143–63.

    Article  Google Scholar 

  33. Leventhal H, Phillips LA, Burns E. The Common-Sense Model of Self-Regulation (CSM): a dynamic framework for understanding illness self-management. J Behav Med. 2016;39(6):935–46.

    Article  PubMed  Google Scholar 

  34. Lazarus RS, Folkman S. The concept of coping. New York, NY, US: Columbia University Press; 1991. 189 p. (Stress and coping: An anthology, 3rd ed).

  35. Hagger MS, Orbell S. Illness representations and emotion in people with abnormal screening results. Psychol Health. 2006;21(2):183–209.

    Article  PubMed  Google Scholar 

  36. Aujla N, Walker M, Vedhara K, Sprigg N. The relationship between patients’ illness beliefs and recovery after stroke. Psychol Health Med. 2019;24(5):551–8.

    Article  CAS  PubMed  Google Scholar 

  37. Keogh KM, White P, Smith SM, McGilloway S, O’Dowd T, Gibney J. Changing illness perceptions in patients with poorly controlled type 2 diabetes, a randomised controlled trial of a family-based intervention: protocol and pilot study. BMC Fam Pract. 2007;8(1):36.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Skinner TC, Khunti K, Carey ME, Dallosso H, Heller S, Davies MJ. Stability and predictive utility, over 3 years, of the illness beliefs of individuals recently diagnosed with Type 2 diabetes mellitus. Diabet Med. 2014;31(10):1260–3.

    Article  CAS  PubMed  Google Scholar 

  39. Sadeghi Akbari A, Cheraghi MA, Kazemnejad A, Nomali M, Zakerimoghadam M. Effect of illness perception correction—based educational program on quality of life and self- care in patients with heart failure: a randomized controlled trial. J Caring Sci. 2019;8(2):89–93.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Siemonsma PC, Stuive I, Roorda LD, Vollebregt JA, Walker MF, Lankhorst GJ, et al. Cognitive treatment of illness perceptions in patients with chronic low back pain: a randomized controlled trial. Phys Ther. 2013;93(4):435–48.

    Article  PubMed  Google Scholar 

  41. Dempster M, Howell D, McCorry NK. Illness perceptions and coping in physical health conditions: A meta-analysis. J Psychosom Res. 2015;79(6):506–13.

    Article  PubMed  Google Scholar 

  42. Brown SM, Bose S, Banner-Goodspeed V, Beesley SJ, Dinglas VD, Hopkins RO, et al. Approaches to addressing post-intensive care syndrome among intensive care unit survivors. A narrative review. Ann Am Thorac Soc. 2019;16(8):947–56.

    Article  PubMed  Google Scholar 

  43. Rousseau AF, Prescott HC, Brett SJ, Weiss B, Azoulay E, Creteur J, et al. Long-term outcomes after critical illness: recent insights. Crit Care. 2021;25(1):108.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Ungar M, Theron L. Resilience and mental health: how multisystemic processes contribute to positive outcomes. Lancet Psychiatry. 2020;7(5):441–8.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We are indebted to A. Wolfe, MD, for assistance in preparing and reviewing the manuscript; Carine Coffre and Frédérique Musset for managing the database; and Diane Maugars and Manon Rouaud for coordinating the study. We are grateful to the medical staff, nurses, and research nurses at the 41 participating centres for their valuable contribution to the successful conduct of the study.

Funding

The RESIREA study and the NUTRIREA-3 study were supported by the Nantes University Hospital. The NUTRIREA-3 study was funded by a 2017 Programme Hospitalier de Recherche Clinique National grant from the French Ministry of Health (#PHRC-17-0213).

Author information

Authors and Affiliations

  1. Laboratoire de Psychologie: Dynamiques Relationnelles Et Processus Identitaires (Psy-DREPI), Université de Bourgogne Franche-Comté, EA7458, Dijon, France

    Alice Mathieu & Alexandra Laurent

  2. CHU Nantes, Movement - Interactions - Performance, MIP, UR 4334, Nantes Université, 44000, Nantes, France

    Jean Reignier & Jean-Baptiste Lascarrou

  3. Médecine Intensive Réanimation, Nantes Université, CHU Nantes, 44000, Nantes, France

    Jean Reignier & Jean-Baptiste Lascarrou

  4. Inserm CIC 1415, Tours, France

    Amélie Le Gouge

  5. Centre Hospitalier Universitaire de Tours, Tours, France

    Amélie Le Gouge

  6. Service de Médecine Intensive Réanimation, Centre Hospitalier d’Argenteuil, Argenteuil, France

    Gaetan Plantefeve

  7. Service de Médecine Intensive Réanimation, Hôpital Cochin, Groupe Hospitalier Paris Centre-Université Paris Cité, Assistance Publique –Hôpitaux de Paris, Paris, France

    Jean-Paul Mira

  8. Service de Médecine Intensive Réanimation, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France

    Laurent Argaud

  9. Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire Angers, Angers, France

    Pierre Asfar

  10. Service de Médecine Intensive Réanimation, Hôpital Nord Franche Comté, Trevenans, France

    Julio Badie

  11. Service de Médecine Intensive Réanimation, Centre Hospitalier de Saint Malo, Saint-Malo, France

    Nicolae-Vlad Botoc

  12. Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France

    Hoang-Nam Bui

  13. Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire de Poitiers, Poitiers, France

    Delphine Chatellier

  14. Service de Médecine Intensive Réanimation, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France

    Louis Chauvelot

  15. Service de Médecine Intensive Réanimation, Centre Hospitalier d’Angoulême, Angoulême, France

    Christophe Cracco

  16. Université Paris Cité ; Assistance Publique –Hôpitaux de Paris, Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire Saint Louis, Paris, France

    Michael Darmon

  17. Service de Réanimation Polyvalente, Centre Hospitalier Bretagne-Atlantique, Vannes, France

    Agathe Delbove

  18. Service de Réanimation Polyvalente, Hôpital Foch, Suresnes, France

    Jérôme Devaquet

  19. Service de Médecine Intensive Réanimation, Hôpital Louis-Mourier, Assistance Publique –Hôpitaux de Paris, Colombes, France

    Louis-Marie Dumont

  20. Service de Médecine Intensive Réanimation, Centre Hospitalier de Chartres, Chartres, France

    Olivier Gontier

  21. Service de Médecine Intensive Réanimation, Centre Hospitalier de Montauban, Montauban, France

    Samuel Groyer

  22. CHU Nantes, INSERM, Nantes Université, Anesthesie Reanimation, CIC 1413, Nantes, France

    Yannick Hourmant

  23. Service de Réanimation Chirurgicale, Hôpital Saint-Eloi, CHU de Montpellier, Montpellier, France

    Samir Jaber

  24. PhyMedExp, INSERM, CNRS, Montpellier, France

    Samir Jaber

  25. Service de Médecine Intensive Réanimation, Centre Hospitalier de Valenciennes, Valenciennes, France

    Fabien Lambiotte

  26. Service de Médecine Intensive Réanimation, Centre Hospitalier de Bigorre, Tarbes, France

    Benjamin Madeux

  27. Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France

    Julien Maizel

  28. Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire de la Réunion, Saint-Denis, La Réunion, France

    Olivier Martinet

  29. Service de Médecine Intensive Réanimation, Hôpital Raymond Poincaré, Assistance Publique Hôpitaux de Paris, Garches, France

    Virginie Maxime

  30. Inserm U 1173, Université de Versailles-Saint Quentin en Yvelines, Versailles, France

    Virginie Maxime

  31. Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire de Tours, CRICS-TRIGGERSEP Network Tours, Tours, France

    Emmanuelle Mercier

  32. Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire d’Orléans, Orléans, France

    Mai-Anh Nay

  33. Médecine Intensive-Réanimation, CHU Lille, 59000, Lille, France

    Saad Nseir

  34. CNRS, Inserm, UMR 8576 - U1285 - UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, Lille University, Lille, France

    Saad Nseir

  35. Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire de Besançon, Besançon, France

    Gael Piton

  36. Université de Franche Comté, EA3920, Besançon, France

    Gael Piton

  37. Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire François Mitterrand, Dijon, France

    Jean-Pierre Quenot

  38. Lipness Team, INSERM, LabExLipSTIC, Université de Bourgogne, Dijon, France

    Jean-Pierre Quenot

  39. INSERM Centres d’Investigation Clinique, Département d’épidémiologie Clinique, Université de Bourgogne, Dijon, France

    Jean-Pierre Quenot

  40. Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire La Cavale Blanche, Brest, France

    Anne Renault

  41. Service de Médecine Intensive Réanimation, Centre Hospitalier de Dieppe, Dieppe, France

    Jean-Philippe Rigaud

  42. Service de Médecine Intensive Réanimation, Hôpitaux Universitaires de Strasbourg, Strasbourg, France

    Francis Schneider

  43. Service de Médecine Intensive Réanimation, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy, France

    Michel Sirodot

  44. Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire Gabriel-Montpied, Clermont-Ferrand, France

    Bertrand Souweine

  45. Service de Médecine Intensive Réanimation, Hôpital Charles Nicolle, Centre Hospitalier Universitaire de Rouen; Normandie Université, UNIROUEN, Inserm U1096, FHU-REMOD-VHF, Rouen, France

    Fabienne Tamion

  46. Service de Médecine Intensive Réanimation, Centre Hospitalier de Lens, Lens, France

    Didier Thévenin

  47. Service de Médecine Intensive Réanimation, Groupe Hospitalier Sud Ile de France, Melun, France

    Nathalie Thieulot-Rolin

  48. Service de Réanimation Chirurgicale, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France

    Francois Tinturier

  49. Service de Médecine Intensive Réanimation, Centre Hospitalier du Mans, Le Mans, France

    Patrice Tirot

  50. Service de Médecine Intensive Réanimation, Centre Hospitalier Départemental de la Vendée, La Roche sur Yon, France

    Isabelle Vinatier

  51. Service de Médecine Intensive Réanimation, Centre Hospitalier de Béthune, Béthune, France

    Christophe Vinsonneau

  52. Department of Anaesthesiology and Critical Care Medicine, Dijon University Medical Centre, Dijon, France

    Alexandra Laurent

  53. Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire Hôtel-Dieu, 30 Bd. Jean Monnet, 44093, Nantes Cedex 1, France

    Jean Reignier

  54. Laboratoire Psy-DREPI, Université de Bourgogne Pôle Aafe, Esplanade Erasme, 21078, Dijon, France

    Alexandra Laurent

Authors
  1. Alice Mathieu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jean Reignier
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Amélie Le Gouge
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gaetan Plantefeve
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jean-Paul Mira
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Laurent Argaud
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Pierre Asfar
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Julio Badie
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Nicolae-Vlad Botoc
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Hoang-Nam Bui
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Delphine Chatellier
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Louis Chauvelot
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Christophe Cracco
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Michael Darmon
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Agathe Delbove
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Jérôme Devaquet
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Louis-Marie Dumont
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Olivier Gontier
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. Samuel Groyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  20. Yannick Hourmant
    View author publications

    You can also search for this author in PubMed Google Scholar

  21. Samir Jaber
    View author publications

    You can also search for this author in PubMed Google Scholar

  22. Fabien Lambiotte
    View author publications

    You can also search for this author in PubMed Google Scholar

  23. Benjamin Madeux
    View author publications

    You can also search for this author in PubMed Google Scholar

  24. Julien Maizel
    View author publications

    You can also search for this author in PubMed Google Scholar

  25. Olivier Martinet
    View author publications

    You can also search for this author in PubMed Google Scholar

  26. Virginie Maxime
    View author publications

    You can also search for this author in PubMed Google Scholar

  27. Emmanuelle Mercier
    View author publications

    You can also search for this author in PubMed Google Scholar

  28. Mai-Anh Nay
    View author publications

    You can also search for this author in PubMed Google Scholar

  29. Saad Nseir
    View author publications

    You can also search for this author in PubMed Google Scholar

  30. Gael Piton
    View author publications

    You can also search for this author in PubMed Google Scholar

  31. Jean-Pierre Quenot
    View author publications

    You can also search for this author in PubMed Google Scholar

  32. Anne Renault
    View author publications

    You can also search for this author in PubMed Google Scholar

  33. Jean-Philippe Rigaud
    View author publications

    You can also search for this author in PubMed Google Scholar

  34. Francis Schneider
    View author publications

    You can also search for this author in PubMed Google Scholar

  35. Michel Sirodot
    View author publications

    You can also search for this author in PubMed Google Scholar

  36. Bertrand Souweine
    View author publications

    You can also search for this author in PubMed Google Scholar

  37. Fabienne Tamion
    View author publications

    You can also search for this author in PubMed Google Scholar

  38. Didier Thévenin
    View author publications

    You can also search for this author in PubMed Google Scholar

  39. Nathalie Thieulot-Rolin
    View author publications

    You can also search for this author in PubMed Google Scholar

  40. Francois Tinturier
    View author publications

    You can also search for this author in PubMed Google Scholar

  41. Patrice Tirot
    View author publications

    You can also search for this author in PubMed Google Scholar

  42. Isabelle Vinatier
    View author publications

    You can also search for this author in PubMed Google Scholar

  43. Christophe Vinsonneau
    View author publications

    You can also search for this author in PubMed Google Scholar

  44. Jean-Baptiste Lascarrou
    View author publications

    You can also search for this author in PubMed Google Scholar

  45. Alexandra Laurent
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

the NUTRIREA-3 Trial Investigators

  • Alice Mathieu
  • , Jean Reignier
  • , Amélie Le Gouge
  • , Gaetan Plantefeve
  • , Jean-Paul Mira
  • , Laurent Argaud
  • , Pierre Asfar
  • , Julio Badie
  • , Nicolae-Vlad Botoc
  • , Hoang-Nam Bui
  • , Delphine Chatellier
  • , Louis Chauvelot
  • , Christophe Cracco
  • , Michael Darmon
  • , Agathe Delbove
  • , Jérôme Devaquet
  • , Louis-Marie Dumont
  • , Olivier Gontier
  • , Samuel Groyer
  • , Yannick Hourmant
  • , Samir Jaber
  • , Fabien Lambiotte
  • , Benjamin Madeux
  • , Julien Maizel
  • , Olivier Martinet
  • , Virginie Maxime
  • , Emmanuelle Mercier
  • , Mai-Anh Nay
  • , Saad Nseir
  • , Gael Piton
  • , Jean-Pierre Quenot
  • , Anne Renault
  • , Jean-Philippe Rigaud
  • , Francis Schneider
  • , Michel Sirodot
  • , Bertrand Souweine
  • , Fabienne Tamion
  • , Didier Thévenin
  • , Nathalie Thieulot-Rolin
  • , Francois Tinturier
  • , Patrice Tirot
  • , Isabelle Vinatier
  • , Christophe Vinsonneau
  • , Jean-Baptiste Lascarrou
  •  & Alexandra Laurent

the Clinical Research In Intensive Care and Sepsis (CRICS-TRIGGERSEP) Group

  • Alice Mathieu
  • , Jean Reignier
  • , Amélie Le Gouge
  • , Gaetan Plantefeve
  • , Jean-Paul Mira
  • , Laurent Argaud
  • , Pierre Asfar
  • , Julio Badie
  • , Nicolae-Vlad Botoc
  • , Hoang-Nam Bui
  • , Delphine Chatellier
  • , Louis Chauvelot
  • , Christophe Cracco
  • , Michael Darmon
  • , Agathe Delbove
  • , Jérôme Devaquet
  • , Louis-Marie Dumont
  • , Olivier Gontier
  • , Samuel Groyer
  • , Yannick Hourmant
  • , Samir Jaber
  • , Fabien Lambiotte
  • , Benjamin Madeux
  • , Julien Maizel
  • , Olivier Martinet
  • , Virginie Maxime
  • , Emmanuelle Mercier
  • , Mai-Anh Nay
  • , Saad Nseir
  • , Gael Piton
  • , Jean-Pierre Quenot
  • , Anne Renault
  • , Jean-Philippe Rigaud
  • , Francis Schneider
  • , Michel Sirodot
  • , Bertrand Souweine
  • , Fabienne Tamion
  • , Didier Thévenin
  • , Nathalie Thieulot-Rolin
  • , Francois Tinturier
  • , Patrice Tirot
  • , Isabelle Vinatier
  • , Christophe Vinsonneau
  • , Jean-Baptiste Lascarrou
  •  & Alexandra Laurent

Contributions

AM, AL, JR, JBL and ALG designed the study. AM, JR, GP, JPM, LA, PA, JB, NVB, HNB, DC, LC, CC, MD, AD, JD, LMD, OG, SG, YH, SJ, FL, BM, JM, OM, VM, EM, MAN, SN, GP, JPQ, AR, JPR, FS, MS, BS, FT, DT, NTR, FT, PT, IV, CV, JBL, and AL approved the study design, coordinated individual sites, participated in the inclusion of study participants, and collected the data. JR and ALG directly accessed and verified all the data reported in the manuscript. ALG performed the statistical analysis. AM wrote the first draft of the manuscript with input from JR and AL. All authors had full access to the study data, revised the manuscript for important intellectual content, and read and approved the final version before submission. All authors accept responsibility for submitting the final manuscript for publication.

Corresponding authors

Correspondence to Jean Reignier or Alexandra Laurent.

Ethics declarations

Ethics approval and consent to participate

RESIREA was a planned study conducted in parallel with the randomised controlled multicentre NUTRIREA-3 trial, which was approved by the competent ethics committee (Comité de Protection des Personnes Sud-Méditerranée 2, #2018-A00424-51). The RESIREA study protocol was approved by the ethics committee of the French Intensive Care Society (CE SRLF 18–19). Specific informed consent for inclusion in the RESIREA study was obtained from the patients, or from their next of kin in patients unable to consent.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests related to this article.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mathieu, A., Reignier, J., Le Gouge, A. et al. Resilience after severe critical illness: a prospective, multicentre, observational study (RESIREA). Crit Care 28, 237 (2024). https://doi.org/10.1186/s13054-024-04989-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s13054-024-04989-x

Keywords

Critical Care

ISSN: 1364-8535