Post-Discharge rehabilitation
Immediate and individually tailored post-acute ICU rehabilitation
efforts should be targeted towards ameliorating problems across all
three PICS domains (physical, mental and cognitive) based on findings
from personalized evaluation. Specialist referral should be sought if
need be.40 Cognitive
rehabilitation41 and the use of ICU
diaries42 are useful in managing PICS-related
cognitive symptoms, thus improving psychosocial well-being. Post ICU
rehabilitation also helps to improve critical illness-related depressive
symptoms and mental health-related quality of life43.
A recent report has also shown cardio-pulmonary rehabilitation for COVID
19 survivors to be safe and effective44.
Tele-consultations using telephone, a seemingly feasible tele-health
option in Africa45, is also an efficient and feasible
alternative in providing psychosocial support to patients, family
members and caregivers after their ICU stay46.
Although evidence for the efficacy of post ICU rehabilitation is rather
inconclusive47, practice guidelines recommend its
implementation considering the complexity of critical illness
presentations and the need to optimize patient outcomes and improve
survivorship35,39,48. Considering the peculiarity of
the healthcare systems in Africa, different countries have put up
guidelines to incorporate key considerations for rehabilitating COVID-19
patients in African settings35. There is hence a need
for close collaboration amongst rehabilitation specialists, community
health service providers and other multi-professional teams with
experience in providing rehabilitation interventions for mental,
cognitive and physical sequelae of critical illness.