Clinical Management and Long-Term Prognosis in Intensive Care

Dear Colleagues,

Critically ill survivors and their families are often unaware of the physical, psychological, and cognitive problems, as well as the reduced quality of life (QoL), which can persist for months or even years after discharge from the intensive care unit (ICU). Consequently, this lack of awareness leads to an underestimation of the long-term impact of critical illness on the functioning of survivors and their loved ones. This set of adverse outcomes is referred to as post-intensive care syndrome (PICS)/post-intensive care syndrome-family (PICS-F). The prevalence of chronically ill patients in critical illness is estimated to be approximately 5–20%. These patients often experience prolonged dependence on organ support, including mechanical ventilation and tracheostomy, and a prolonged length of stay (LOS) in the ICU. Although difficult to define, the concept of chronic critical illness is typically considered after 10–14 days of ICU stay.

Strategies such as early rehabilitation, implementation of the ABCDEF bundle, and promoting communication about goals and expectations for care are crucial to improving patient outcomes and helping patients return to better health, even if not fully to their pre-illness baseline. Many healthcare facilities are striving to increase patient and family participation in decision-making, pursuing shared decision-making. Although evidence is limited, shared decision-making is likely to improve patient and family outcomes and satisfaction with care. To make decision-making feasible, we invite you to share your experiences and insights on patient-relevant outcomes. This will enable the development of models for long-term outcomes for patients who survive ICU hospitalization, such as quality of life (QoL) and patient-reported outcome measures (PROMs), contributing to personalized healthcare decision-making in the ICU.

Prof. Dr. Wioletta Mędrzycka-Dąbrowska
Guest Editor

Dr. Sandra Lange
Guest Editor Assistant

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