Beyond survival: Nourishing recovery from the ICU to the long term

Each month, ESICM’s Topic of the Month brings together curated scientific content, expert interviews and key resources from across our 14 specialist sections. An opportunity to explore a specific theme in depth, engage with the latest evidence, and stay at the forefront of intensive care practice.

Because in a field that evolves as rapidly as ours, continuous learning is the foundation of better care for our patients.

The Rehabilitation & PICS section, one of ESICM’s newest (launched in 2025) and led by Stefan Schaller, is a multidisciplinary community spanning the full continuum of critical illness recovery — from early ICU rehabilitation to long-term follow-up. Focused on neuromuscular and cognitive recovery, psychosocial health, and PICS in both patients and families, the section drives collaborative research, evidence-based education, and innovation in survivorship care.

The Feeding, Rehabilitation, Endocrinology & Metabolism (FREM) section, led by Christian Stoppe, drives collaborative research and evidence-based practice across nutrition, endocrinology, and metabolism in intensive care. Beyond advancing scientific knowledge and delivering high-quality education, the section is committed to sustainability through a Green ICU approach, and to fostering an inclusive community that bridges experienced intensivists, younger clinicians, nurses, dietitians, and allied health professionals.

This April, both sections join forces to shine a light on one of intensive care’s most pressing challenges: what happens after survival, and how we can ensure ICU patients don’t just live, but truly recover.

The connection between these two sections is not incidental; it is foundational. Nutritional status directly influences rehabilitation capacity. Metabolic and endocrine recovery shapes cognitive and physical outcomes. FREM and Rehab & PICS are two sides of the same coin: restoring the whole person, not just stabilising the acute patient.

This month, we invite you to engage with our featured scientific interview and suggested resources, and to reflect on how nutrition, metabolism, and rehabilitation intersect in your own clinical practice.

Because recovery is not a destination, it is a process that we must actively build, from the first ICU day to the last follow-up appointment.

RESOURCES: 

 Webinars & Podcasts
🔹Gastrointestinal failure and bowel ischaemia; there is more than ‘gut feeling’!
🔹Unlocking Critical Care Nutrition: Latest Insights & Debates
🔹Improving comfort and safety in the ICU

LIVE Top Talks
🔹Optimising nutrition
🔹Consequence of persistent catabolism in recovery

ICM Articles
🔹Effects of The Caregiver Pathway intervention on symptoms of post-intensive care syndrome among family caregivers to critically ill patients
🔹Post-intensive care syndrome is a potential consequence of critical care: can intensivists afford to look away?
🔹A new era for ICU-acquired weakness research—from mechanisms to meaningful recovery

SCIENTIFIC INTERVIEW:

In this month’s scientific interview, Angélique De Man (Amsterdam, Netherlands) tackles an often overlooked yet critical aspect of ICU nutrition: micronutrient supplementation. Drawing on current evidence and clinical guidelines, she walks us through the when, what, and how of micronutrient support in critically ill patients, exploring how conditions such as critical illness, surgery, and malnutrition alter the timing and urgency of supplementation. She addresses the consequences of leaving deficiencies unaddressed, from impaired immune function to delayed recovery. She examines how factors like absorption capacity and metabolic shifts should guide the route and dosing of administration.