[Why a post-intensive care consultation ?] / Pourquoi une consultation post-soins intensifs ?

The progress of intensive care medicine allows the survival of patients with severe critical illness. However, the quality of life of patients with a prolonged stay in intensive care unit (ICU) can be poor. The physical and psychological consequences are due more to the intensive care than the primary diagnoses. Moreover, a stay of a beloved in an ICU impacts heavily on the relatives. The service of Geneva ICU developed a specific model of care for patients with a prolonged stay and seeks to establish a follow-up consultation for these patients. The aim would be to fill the memory gaps, explain the events during their stay, and detect potential complications. This project fits in the follow-up of complex situations in tight collaboration with the family doctors of such patients.

Le progrès de la médecine intensive permet la survie de patients gravement atteints dans leur santé. Toutefois, les conditions de survie de ces patients, surtout après un séjour prolongé aux soins intensifs (SI), sont parfois difficiles. Les atteintes physiques et psychiques à moyen et long termes sont propres aux événements vécus aux SI, plus que les conséquences des diagnostics d'admission aux SI. De plus, ce séjour impacte lourdement sur les proches de ces patients. Les SI de Genève ont mis en place une structure de suivi durant le séjour prolongé de patients et souhaite aujourd'hui leur offrir un suivi après les SI. Le but est de combler les lacunes de mémoire de leur séjour, expliquer les événements incompris et détecter d'éventuelles complications. Ce projet s'insère dans le suivi complexe de ces patients avec les médecins traitants.

The chronic critical illness: a new disease in intensive care.

Advances in intensive care medicine have created a new disease called the chronic critical illness. While a significant proportion of severely ill patients who twenty years ago would have died survive the acute phase, they remain heavily dependent on intensive care for a prolonged period of time. These patients, who can be called "Patient Long Séjour" in French (PLS) or Prolonged Length of Stay patients in English, develop specific health issues that are still poorly recognised. They require special care, which differs from treatments that are given during the acute phase of their illness. A multidisciplinary team dedicated to ensuring their management and follow-up acquired a wide range of knowledge and expertise about these PLSs. Many new monitoring tools and diverse human approaches were implemented to ensure that care was targeted to these patients' needs. This multimodal care management aims to optimise the patients' and their families' quality of life during and following intensive care, whilst maintaining the motivation of the healthcare team of the unit. The purpose of this article is to present new management techniques to hospital and ambulatory caregivers, physicians and nurses, who may be taking care of such patients.