Abstract

VAN DER MERWE, E  and  PARUK, F. Quantifying the burden of the post-ICU syndrome in South Africa: A scoping review of evidence from the public health sector. South. Afr. j. crit. care (Online) [online]. 2022, vol.38, n.2, pp.82-87. ISSN 2078-676X.  http://dx.doi.org/10.7196/SAJCC.2022.v38i2.527.

BACKGROUND. The post-ICU syndrome (PICS) comprises unexpected impairments in physical, cognitive, and mental health after intensive care unit (ICU) discharge, and is associated with a diminished health-related quality of life (HRQOL). A Cochrane review recommended more research in this field from low- and middle-income countries. OBJECTIVE. This review aims to examine the extent and nature of publications in the field of PICS in the South African (SA) public health sector. Findings of available local research are contextualised through comparison with international data. METHODS. A comprehensive literature search strategy was employed. Inclusion criteria comprised publications enrolling adult patients following admission to SA public hospital ICUs, with the aim to study the main elements of PICS (ICU-acquired neuromuscular weakness, neurocognitive impairment, psychopathology and HRQOL). RESULTS. Three studies investigated physical impairment, 1 study psychopathology, and 2 studies HRQOL. Recommended assessment tools were utilised. High rates of attrition were reported. Neuromuscular weakness in shorter-stay patients had recovered at 3 months. Patients who were ventilated for >5 days were more likely to be impaired at 6 months. The study on psychopathology reported high morbidity. The HRQOL of survivors was diminished, particularly in patients ventilated for >5 days. CONCLUSION. This review found a paucity of literature evaluating PICS in the SA public health sector. The findings mirror those from international studies. Knowledge gaps pertaining to PICS in medical, surgical and HIV-positive patients in SA are evident. No publications on neurocognitive impairment or the co-occurrence of PICS elements were identified. There is considerable scope for further research in this field in SA.

Keywords : Post intensive care syndrome; critical care; South Africa; review; anxiety disorder; depressive mood disorder; post-traumatic stress disorder; health-related quality of life; physical impairment; neurocognitive impairment; ICU-acquired neuromuscular weakness.

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