Critical and Acute Illness Recovery and Engagement Program

CAIRE

The Critical and Acute Illness Recovery and Engagement Program

Our program aims to provide clinical management, education, and guidance to help adult survivors of critical illness as well as adult patients with Long COVID and other infection-associated chronic conditions. We use a consultation model of care in which we aim to personalize principles of recovery to help patients and providers to better address the most common chronic symptoms that can plague patients after an episode of critical illness or after acute infections like SARS-CoV-2.

Appointment Line: 503-494-9006

In addition to seeing patients and teaching at OHSU, we are also involved in research aimed to further understanding post-intensive care syndrome (PICS), Long COVID and other infection associated chronic conditions.  

Patients recovering from critical and acute illnesses may experience new or worsening cognitive, psychological, and physical symptoms.

Some of these include:

  • Breathing difficulties
  • Weakness and balance problems
  • Pain & numbness
  • Memory & concentration difficulties
  • Anxiety, Depression, or Post-Traumatic Stress Symptoms
  • Sleep problems
  • Dizziness, headache, cold hands and feet, palpitations
  • Post-exertional malaise (PEM)

The patients who are eligible to see CAIRE after the ICU need to have had:

  • Acute respiratory failure or acute respiratory distress syndrome (ARDS)
  • Severe sepsis or septic shock
  • ≥48 hours of needing life support technologies such as: 
    • invasive mechanical ventilation;
    • high flow nasal cannula;
    • new continuous positive airway pressure (CPAP), or bilevel positive airway pressure (BiPAP);
    • Extracorporeal Membrane Oxygenation (ECMO);
    • mechanical circulatory support (Impella, intra-ortic balloon pump ( IABP)
  • a need for urgent cardiovascular interventions such as catheterization, coronary artery bypass graft (CABG) (e.g., PCI, CABG)
  • continuous administration of neuromuscular blockers, sedatives, IV diuretics, or vasopressors/inotropes

The patients who are eligible to see CAIRE for an Infection-Associated Chronic Condition (IACC) will need to have new or worsening symptoms after an acute infection like SARS-CoV-2 that have lasted ≥ 3 months. CAIRE focuses on patients with any of the following symptoms:

  • shortness of breath
  • cough
  • fatigue (physical or cognitive)
  • post-exertional malaise
  • exercise intolerance
  • cognitive or communication changes (brain fog)
  • orthostatic intolerance or dysautonomia  

Managing these conditions requires an inter-disciplinary, team-based approach. Our team includes clinicians, a nurse practitioner, a nurse navigator, a psychologist and we work closely with our  research team.

Photograph of Dr. Aluko Hope

Dr. Aluko Hope, CAIRE Clinic Director

Photograph of Dr. Kinsley Hubel

Dr. Kinsley Hubel, Pulmonary Critical Care & ECMO Faculty

Photograph of Dr. Khoa Nguyen

Dr. Khoa Nguyen, Critical Care Cardiologist

CAIRE Team Photo
Photograph of CAIRE Team; from left to right: Dr. Aluko Hope, Dr. Kinsley Hubel, Dr. Khoa Nguyen, Jennifer Arnold, RN

PT

PT Protocol

Bateman Horne