Dealing with the critical care aftermath: where to from here?

One of the most important developments in critical care over the last 10 years has been the recognition that while overall survival is important, the quality of life post discharge is crucial (1). The rate of recurring major illness and/or mortality is increased in the year after ICU discharge and the patient may have residual physical, cognitive and psychosocial problems lasting from 5 to 15 years (2). There has been a proliferation of research directed as to the actual nature, distribution and degree of impairments and to interventional studies to prevent or ameliorate these poor outcomes both early in intensive care and in post intensive care follow up. Despite this most primary care clinicians have little knowledge of the potential and range of impairments post critical care discharge. Lack of continuity and co-ordination of care is evident in most countries and centres.