Understanding and Improving Critical Care Survivorship

In recent decades, the longevity revolution, coupled with improvements in our treatments for acute and chronic illnesses, has contributed to an unprecedented increase in the number of survivors of critical illness.1 From multiple studies throughout the years, it has become clear that our intensive care unit (ICU) survivors experience high rates of new physical impairments and disabilities, new cognitive impairments akin to moderate traumatic brain injury, and psychological distress that can include depression or posttraumatic symptoms.2 Their caregivers and loved ones suffer fi nancial, social, emotional, and psychiatric impairments that can affect their quality of life. The terms post– intensive care syndrome (PICS) and post–intensive care syndrome–family (PICS-F) draw attention to these new and/or worsening impairments in ICU survivors and their families, respectively.3 What factors are associated with PICS remains unclear, and developing and testing ICU aftercare models to address these survivorship issues is a pressing challenge for many health systems. We argue that the moral imperative to provide holistic care for ICU survivors is strong and that waiting for clinical research methods to inform the best care approaches would be foolhardy. We believe that health care systems need to design and evaluate care approaches that match their local contexts and that academic societies and other learning communities in critical care can advance the fi eld by incentivizing such innovation.