Advances in post intensive care unit care: A narrative review

Abstract

As the treatment options, modalities and technology have grown, mortality in intensive care unit (ICU) has been on the decline. More and more patients are being discharged to wards and in the care of their loved ones after prolonged treatment at times and sometimes in isolation. These survivors have a lower life expectancy and a poorer quality of life. They can have substantial familial financial implications and an economic impact on the healthcare system in terms of increased and continued utilisation of services, the so-called post intensive care syndrome (PICS). But it is not only the patient who is the sufferer. The mental health of the loved ones and family members may also be affected, which is termed as PICS-family. In this review, we shall be reviewing the definition, epidemiology, clinical features, diagnosis and evaluation, treatment and follow up of PICS. We shall also focus on measures to prevent, rehabilitate and understand the ICU stay from patients’ perspective on how to redesign the ICU, post ICU care needs for a better patient outcome.

Keywords: Post intensive care syndrome, Post intensive care syndrome-family, Guidelines, Post intensive care syndrome clinics, Impediments

Core Tip: Core priorities of critical illness survivors should be a part of the stakeholder-driven clinical guidelines and quality measures for post-intensive care unit (ICU) care. Future research should extend these findings among other stakeholders (e.g., family members and healthcare providers) and determine barriers and facilitators to patient-centered post-ICU care. It is not too far-fetched to think of a multi-professional patient centric critical care team that provides the right care to the right patient at the right time throughout and after the acute illness is over. What we need to change to bring in the future is how we use data, devices, and new technologies to continue to strive toward that goal.