Unmasking the hidden aftermath: postintensive care unit sequelae, discharge preparedness, and long-term follow-up

Abstract

A significant portion of individuals who have experienced critical illness encounter new or exacerbated impairments in their physical, cognitive, or mental health, commonly referred to as postintensive care syndrome. Moreover, those who survive critical illness often face an increased risk of adverse consequences, including infections, major cardiovascular events, readmissions, and elevated mortality rates, during the months following hospitalization. These findings emphasize the critical necessity for effective prevention and management of long-term health deterioration in the critical care environment. Although conclusive evidence from well-designed randomized clinical trials is somewhat limited, potential interventions include strategies such as limiting sedation, early mobilization, maintaining family presence during the intensive care unit stay, implementing multicomponent transition programs (from intensive care unit to ward and from hospital to home), and offering specialized posthospital discharge follow-up. This review seeks to provide a concise summary of recent medical literature concerning long-term outcomes following critical illness and highlight potential approaches for preventing and addressing health decline in critical care survivors.

Figure 1. Potential risk factors for psychiatric morbidity following intensive care unit discharge include preexisting psychiatric illness and the presence of psychiatric symptoms during hospitalization.(13,48)

The emojis represent the quality of life of patients based on the number of psychiatric morbidities. ICU - intensive care unit; PTSD - posttraumatic stress disorder.

Figure 2. Recommended approach to functional assessments across the continuum of critical illness and recovery.

ICU - intensive care unit.

Figura 1. Os potenciais fatores de risco para morbidade psiquiátrica após alta da unidade de terapia intensiva incluem doença psiquiátrica preexistente e sintomas psiquiátricos durante a internação.(13,48)

Os emojis representam a qualidade de vida dos pacientes de acordo com o número de morbidades psiquiátricas. UTI - unidade de terapia intensiva; TEPT - transtorno do estresse pós-traumático.

Figura 2. Abordagem recomendada para avaliações funcionais ao longo da doença crítica e recuperação.

UTI - unidade de terapia intensiva.