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Review
. 2024 Jan 12;12(1):2.
doi: 10.1186/s40560-023-00716-w.

Post-intensive care syndrome follow-up system after hospital discharge: a narrative review

Nobuto Nakanishi  1 , Keibun Liu  2   3   4 , Junji Hatakeyama  5 , Akira Kawauchi  6 , Minoru Yoshida  7 , Hidenori Sumita  8 , Kyohei Miyamoto  9 , Kensuke Nakamura  10
Affiliations
Review

Post-intensive care syndrome follow-up system after hospital discharge: a narrative review

Nobuto Nakanishi et al. J Intensive Care. .

Abstract

Background: Post-intensive care syndrome (PICS) is the long-lasting impairment of physical functions, cognitive functions, and mental health after intensive care. Although a long-term follow-up is essential for the successful management of PICS, few reviews have summarized evidence for the efficacy and management of the PICS follow-up system.

Main text: The PICS follow-up system includes a PICS follow-up clinic, home visitations, telephone or mail follow-ups, and telemedicine. The first PICS follow-up clinic was established in the U.K. in 1993 and its use spread thereafter. There are currently no consistent findings on the efficacy of PICS follow-up clinics. Under recent evidence and recommendations, attendance at a PICS follow-up clinic needs to start within three months after hospital discharge. A multidisciplinary team approach is important for the treatment of PICS from various aspects of impairments, including the nutritional status. We classified face-to-face and telephone-based assessments for a PICS follow-up from recent recommendations. Recent findings on medications, rehabilitation, and nutrition for the treatment of PICS were summarized.

Conclusions: This narrative review aimed to summarize the PICS follow-up system after hospital discharge and provide a comprehensive approach for the prevention and treatment of PICS.

Keywords: Assessments; Intensive care unit; Nutrition; PICS; Rehabilitation.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Positions and roles in the PICS follow-up clinic. In the PICS follow-up clinic, physicians, nurses, physiotherapists, dietitians, pharmacists, and psychologists play specialized roles in the management of patients with PICS and their families. The clinic aims to reintegrate PICS patients and their families back into society through the importance of multidisciplinary cooperation
Fig. 2
Fig. 2
Interventions in the PICS follow-up system after discharge. Patients recovering from critical illness may receive interventions from medical staff in some PICS follow-up systems, in which the PICS follow-up clinic functions as the center. These systems may consist of a multi-disciplinary team for various approaches to PICS. They mainly provide patients with interventions involving medication, rehabilitation, and nutrition therapy based on a PICS evaluation in the same system
Fig. 3
Fig. 3
Rehabilitation programs from hospital discharge to reintegration into society. Rehabilitation programs include physical therapy, respiratory muscle training, swallowing exercises, occupational therapy, cognitive rehabilitation, and mental care
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