Post-ICU care after a long intensive care admission: a Dutch inventory study

Background: The growing awareness of the long-term consequences of critical care led to various post intensive care unit (ICU) interventions for patients after their ICU admission. The aim of this study was to describe which post-ICU interventions are applied by Dutch ICUs. Methods: A survey was conducted among all non-paediatric ICUs in the Netherlands. The person most familiar with the local post-ICU care process, the ICU representative, was asked to complete the questionnaire. The survey consisted of 41 questions regarding ICU characteristics, awareness of post-ICU syndrome (PICS), and forms of early in-hospital and late post-discharge post-ICU care. Data were collected from February until April 2018. Results: The response rate was 97% (77 out of 79). All ICU representatives were aware of PICS. The most common interventions were in-hospital follow-up by ICU clinicians and the use of ICU diaries. Except for one ICU, all applied late post-ICU care. This varied from official outpatient post-ICU clinics (52%) to a post-ICU care app (12%). When asked, most respondents thought that PICS should primarily be recognised and treated by the general practitioner. Conclusion: Dutch ICUs provide a large variation of post-ICU care. Evidence of effectiveness is scarce and guidelines are not available. Randomised controlled trials and guidelines which include the involvement of general practitioners are needed to improve post-ICU care in the Netherlands.