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7.5 - Follow-Up after Critical Illness

from Section 7 - Comfort and Recovery

Published online by Cambridge University Press:  27 July 2023

By
Joel Meyer  and
Andy Slack
Edited by
Ned Gilbert-Kawai ,
Debashish Dutta  and
Carl Waldmann
Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. Post-intensive care syndrome (PICS) affects between 40 and 60 per cent of critical illness survivors, and manifests as new impairments of cognitive, psychological and/or physical function.

  2. 2. Major risk factors for PICS include >72 hours of mechanical ventilation, prolonged ICU delirium, maternal/obstetric critical illness and baseline physical and mental health co-morbidities.

  3. 3. The typical service model of follow-up care includes a face-to-face outpatient review approximately 2–3 months following discharge home, with follow-up visits at 6 and 12 months where required.

  4. 4. Physical, cognitive, psychological and global clinical outcomes should be evaluated using domain-specific tools and assessments.

  5. 5. Critical care recovery clinics provide an important opportunity to reconnect with patients and ‘re-humanise’ the ICU care delivered.

Keywords

post-intensive care syndromecognitivepsychologicalphysicaloutcomes
Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
 , pp. 666 - 670
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Azoulay, E, Vincent, JL, Angus, DC, et al. Recovery after critical illness: putting the puzzle together – a consensus of 29. Crit Care 2017;21:296.CrossRefGoogle ScholarPubMed
Cuthbertson, BH, Wunsch, H. Long-term outcomes after critical illness. The best predictor of the future is the past. Am J Respir Crit Care Med 2016;194:132–4.CrossRefGoogle ScholarPubMed
Needham, DM, Sepulveda, KA, Dinglas, VD, et al. Core outcome measures for clinical research in acute respiratory failure survivors. An International Modified Delphi Consensus study. Am J Respir Crit Care Med 2017;196:1122–30.CrossRefGoogle ScholarPubMed
Schofield-Robinson, OJ, Lewis, SR, Smith, AF, McPeake, J, Alderson, P. Follow-up services for improving long-term outcomes in intensive care unit (ICU) survivors. Cochrane Database Syst Rev 2018;2:CD012701.Google Scholar
Sevin, CM, Jackson, JC. Post-ICU clinics should be staffed by ICU clinicians. Crit Care Med 2019;47:268–72.CrossRefGoogle ScholarPubMed
Wang, T, Derhovanessian, A, De Cruz, S, et al. Subsequent infections in survivors of sepsis: epidemiology and outcomes. J Intensive Care Med 2014;29:87–95.CrossRefGoogle ScholarPubMed

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