Post-ICU Care in the Outpatient Setting.

Area of Science:

• Critical Care Medicine
• Primary Care
• Post-Intensive Care Syndrome (PICS)

Background:

• Over 5 million patients annually admitted to U.S. intensive care units (ICUs) survive and require outpatient follow-up.
• An increasing number of ICU survivors necessitate ongoing care for potential post-discharge complications.
• Family physicians play a crucial role in managing the long-term health of ICU survivors.

Purpose of the Study:

• To outline essential screening and management strategies for family physicians caring for post-ICU patients.
• To identify risk factors and preventative measures for post-ICU complications.
• To emphasize the importance of addressing physical, mental, and cognitive health after ICU discharge.

Main Methods:

• Review of risk factors for post-ICU complications, including prior ICU admissions, comorbidities, and ventilation duration.
• Recommendations for standardized screening tools for depression, anxiety, insomnia, and cognitive impairment.
• Guidance on physical examination, laboratory evaluation, and the role of exercise regimens.
• Consideration of specific needs for COVID-19 survivors, including transmission risk and telemedicine options.

Main Results:

• Prolonged mechanical ventilation, higher opioid exposure, prior ICU admissions, and comorbidities are key risk factors.
• Early nutritional support and mobilization in the ICU mitigate complication risks.
• Screening for mental health and cognitive issues, alongside assessment of weakness and functional impairment, is vital.
• Exercise programs demonstrate benefit in reducing post-ICU complications.

Conclusions:

• Family physicians require preparedness for comprehensive outpatient management of ICU survivors.
• Proactive screening and targeted interventions are essential for addressing post-ICU complications.
• Telemedicine offers a valuable modality for managing COVID-19 survivors and reducing exposure risks.