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are not self-sufficient patients during the first week after hospital discharge&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a> Functional independence improves with early rehabilitation programs&#44; but regaining muscle mass and strength can take weeks&#44; months or even years after hospital discharge&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">6</span></a> Recently&#44; muscle weakness measured using the Clinical Frailty Score has been associated with higher mortality rates at 3 and 12 months&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">ICU-acquired muscle weakness is a clinical diagnosis&#46; The typical presentation in the acute phase is symmetric muscle weakness that affects the limbs and respiratory muscles&#46; Terms such as polyneuropathy&#59; myopathy in critically ill patients&#59; or neuromyopathy speak to us about the underlying condition and are identified through neurophysiology or muscle biopsy&#46; Not all patients with ICU-acquired muscle weakness show polyneuropathy or critical illness myopathy&#46; Not all patients with a neurophysiological diagnosis of neuropathy or myopathy have ICU-acquired muscle weakness&#44; even though the risk of developing it is high&#46; Among the physiopathological findings&#44; the calpain and ubiquitine-proteasome mediated myofibrillar protein rupture is one of the key elements&#44; especially during the sepsis&#44; that leads to a loss of myosin filaments&#59; sarcomere disassembly&#59; and muscle dystrophy&#46; This increase in the rate of muscle protein ruptures gets worse with immobilization which&#44; to a greater or lesser extent&#44; is one of the constants of critically ill patients&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">The office of intensive outpatient care</span><p id="par0035" class="elsevierStylePara elsevierViewall">The identification and management of the PICS requires one multidisciplinary team&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Since 2009&#44; the guidelines published by the U&#46;K&#46; National Health Service through its National Institute for Health and Care Excellence recommends all its hospitals to review the provision of follow-up units for critically ill patients&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">9</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">In our country&#44; the Hospital Universitario La Paz Critical Care Medicine Department &#40;CCMD&#41; has started a program for PICS detection and follow-up&#46; Without leaving out the strategies aimed at its prevention&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> the elements of the project focus on the follow-ups conducted at the hospital floors and the check-ups conducted at the office of intensive outpatient care of patients at risk of developing PICS&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The patient at risk is assessed at the hospital floor 5&#8211;7 days after being discharged from the CCMD&#44; and should he still be eligible for assessment&#44; a new appointment is arranged three &#40;3&#41; months later at the office of intensive outpatient care&#46; The actions that will be conducted there are&#58; anamnesis from the moment of hospital discharge&#59; physical examination&#59; assessment of pulmonary function&#59; assessment of muscle strength&#59; functional assessment&#59; and quality of life&#44; psychological and cognitive assessments&#46; Based on the characteristics of the patients&#44; a new appointment will be arranged with each individual 6&#44; 9 and 12 months later or&#44; in the absence of alterations requiring further medical appointments&#44; the patient will be discharged from the hospital&#46; Additionally&#44; based on the alterations found&#44; the patients can be referred to the corresponding medical specialists &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; The CCMD teams up with the unit of psychiatry and the rehab unit for the implementation of this program&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">The conceptual changes of our medical specialty have brought the intensivist out of the CCMD&#46; Following in the footsteps of this philosophy&#44; the project aims at providing better healthcare to the critically ill patient before&#44; during&#44; and &#8220;after&#8221; the resolution of his critical condition<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">11</span></a> &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; Therefore&#44; the answer to the question posed at the beginning of this point of view letter is affirmative&#46; One multidisciplinary team coordinated by the intensivist&#44; who has been following the clinical trajectory of the patient during his stay at the CCMD&#44; is the strategy that should be followed in order to achieve the final goal of intensive medicine&#44; that is&#44; bring back the patient to his activities of daily living&#8211;both professional and socially in optimal health conditions both physically and mentally&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflict of interests</span><p id="par0060" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest whatsoever&#46;</p></span></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Extremera P&#44; A&#241;&#243;n JM&#44; Garc&#237;a de Lorenzo A&#46; &#191;Est&#225;n justificadas las consultas externas de medicina intensiva&#63; Med Intensiva&#46; 2018&#59;42&#58;110&#8211;113&#46;</p>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Program of detection and follow-up of post-intensive care syndromes&#46; Critical Care Medicine Department&#46; Hospital Universitario La Paz-Carlos III&#46;</p>"
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          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Model of critical condition&#46; Edited by Angus and Carlet&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">11</span></a> CCMD&#58; critical care medicine department&#46; <span class="elsevierStyleSup">a</span> Set of prevention measures &#8216;ABCDEF&#8217;&#58; &#40;A&#41; prevention and management of pain&#59; &#40;B&#41; sedative withdrawal test&#46; Spontaneous breathing trial&#59; &#40;C&#41; choice of analgesia and sedation&#59; &#40;D&#41; prevention and management of delirium&#59; &#40;E&#41; early mobilization&#59; and &#40;F&#41; involvement of the families&#46;</p>"
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          "leyenda" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">ADL&#58; Activities of daily living&#46; ARDS&#58; Acute Respiratory Distress Syndrome&#46; MODS&#58; Multiple organ dysfunction syndrome&#46; MV&#58; Mechanical ventilation&#46; PTSD&#58; Post-traumatic stress disorder&#46; CRA&#58; Cardiorespiratory arrest&#46;</p>"
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Complication&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Description&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Risk factors&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Natural history&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Physical function&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Impairment of ADL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Sepsis&#46; ARDS&#46; MV<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>7 days&#46; MODS&#46; Poor glucose regulation&#46; Age&#46; Vasoactive drugs&#46; Corticosteroids&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Improvement of ADL in a matter of months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pulmonary function&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Impaired spirometry&#44; lung volumes and diffusing capacity<br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Duration of MV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Usually mild during the first year&#44; but it can remain for another five years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">Psychiatric</td><td class="td" title="table-entry  " align="left" valign="top">1&#46; Depression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">Sepsis&#44; ARDS&#44; trauma&#44; hypoglycemia&#44; hypoxemia&#44; delusional memories&#46; Sedation&#44; former unemployment&#46;</td><td class="td" title="table-entry  " align="left" valign="top">1&#46; Depression&#58; It can improve during the first year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">2&#46; Anxiety&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46; Anxiety&#58; It can remain beyond the first year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">3&#46; PTSD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Women&#44; Age &#60;50 years old&#46; Alcoholism&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46; PTSD&#58; Poor improvement during the first year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="4" align="left" valign="top">Cognitive</td><td class="td" title="table-entry  " rowspan="4" align="left" valign="top">Memory disorder&#46; Attention&#46; Executive function&#46; Speed of mental processing&#46; Visual-spatial ability</td><td class="td" title="table-entry  " align="left" valign="top">Delirium&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="4" align="left" valign="top">Significant improvement during the first year&#46; Residual deficit up to six years</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sepsis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ARDS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Other &#40;glucose dysregulation&#44; duration of MV&#44; hypotension&#44; CRA&#44; &#8230;&#41;&nbsp;\t\t\t\t\t\t\n
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      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:11 [
            0 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Improving long-term outcomes after discharge from intensive care unit&#58; report from a stakeholders&#8217; conference"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;M&#46; Needham"
                            1 => "J&#46; Davidson"
                            2 => "H&#46; Cohen"
                            3 => "R&#46;O&#46; Hopkins"
                            4 => "C&#46; Weinert"
                            5 => "H&#46; Wunsch"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/CCM.0b013e318232da75"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2012"
                        "volumen" => "40"
                        "paginaInicial" => "502"
                        "paginaFinal" => "509"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21946660"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Posttraumatic stress disorder in critical illness survivors&#58; a metaanalysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46;M&#46; Parker"
                            1 => "T&#46; Sricharoenchai"
                            2 => "S&#46; Raparla"
                            3 => "K&#46;W&#46; Schnek"
                            4 => "O&#46;J&#46; Bienvenu"
                            5 => "D&#46;M&#46; Needham"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/CCM.0000000000000882"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2015"
                        "volumen" => "43"
                        "paginaInicial" => "1121"
                        "paginaFinal" => "1129"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25654178"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Psychiatric symptoms in acute respiratory distress syndrome survivors&#58; a 1-year national multicenter study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Hung"
                            1 => "A&#46;M&#46; Parker"
                            2 => "O&#46;J&#46; Bienvenu"
                            3 => "V&#46;D&#46; Dinglas"
                            4 => "E&#46; Colantuoni"
                            5 => "R&#46;O&#46; Hopkins"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/CCM.0000000000001621"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2016"
                        "volumen" => "44"
                        "paginaInicial" => "954"
                        "paginaFinal" => "965"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26807686"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term cognitive impairment after critical illness"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46;P&#46; Pandharipande"
                            1 => "T&#46;D&#46; Girard"
                            2 => "J&#46;C&#46; Jackson"
                            3 => "A&#46; Morandi"
                            4 => "J&#46;L&#46; Thompson"
                            5 => "B&#46;T&#46; Pun"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1301372"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2013"
                        "volumen" => "369"
                        "paginaInicial" => "1306"
                        "paginaFinal" => "1316"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24088092"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Poor functional status immediately after discharge from an intensive care unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Van der Schaaf"
                            1 => "D&#46;S&#46; Dettling"
                            2 => "A&#46; Beelen"
                            3 => "C&#46; Lucas"
                            4 => "D&#46;A&#46; Dongelmans"
                            5 => "F&#46; Nollet"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1080/09638280701673559"
                      "Revista" => array:6 [
                        "tituloSerie" => "Disabil Rehabil"
                        "fecha" => "2008"
                        "volumen" => "30"
                        "paginaInicial" => "1812"
                        "paginaFinal" => "1818"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19031208"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Neuromuscular sequelae of critical illness"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "N&#46; Latronico"
                            1 => "I&#46; Shehu"
                            2 => "E&#46; Seghelini"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Opin Crit Care"
                        "fecha" => "2005"
                        "volumen" => "11"
                        "paginaInicial" => "381"
                        "paginaFinal" => "390"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16015120"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Frailty and subsequent disability and mortality among patients with critical illness"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46;E&#46; Brummel"
                            1 => "S&#46;P&#46; Bell"
                            2 => "T&#46;D&#46; Girard"
                            3 => "P&#46;P&#46; Pandharipande"
                            4 => "J&#46;C&#46; Jackson"
                            5 => "A&#46; Morandi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/rccm.201605-0939OC"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2017"
                        "volumen" => "196"
                        "paginaInicial" => "64"
                        "paginaFinal" => "72"
                        "link" => array:1 [
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Are outpatient clinics justified in intensive care medicine?
¿Están justificadas las consultas externas de medicina intensiva?
P. Extremeraa, J.M. Añóna,b,
Corresponding author
jmaelizalde@gmail.com

Corresponding author.
, A. García de Lorenzoa
a Servicio de Medicina Intensiva, Hospital Universitario La Paz-Carlos III, IdiPAZ, Madrid, Spain
b CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Program of detection and follow-up of post-intensive care syndromes&#46; Critical Care Medicine Department&#46; Hospital Universitario La Paz-Carlos III&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Traditionally&#44; the goal of intensive medicine has been to reduce short-term mortality yet&#44; today&#44; the management of critically ill patients should focus on goals that go far beyond survival&#46; It is estimated that&#44; at least&#44; half of the survivors of critical conditions will end up showing symptoms associated with the post-intensive care syndrome &#40;PICS&#41;&#8211;an entity including health issues that the patient displays after leaving the critical condition such as psychiatric&#44; cognitive&#44; and physical disorders&#46; The risk factors vary based on the area of the PICS element studied<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">1</span></a> &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Psychiatric disorders</span><p id="par0010" class="elsevierStylePara elsevierViewall">PICS-associated psychiatric disorders include post-traumatic stress disorders &#40;PTSD&#41;&#44; anxiety&#44; and depression&#46; PTSD is associated with terrifying experiences during ICU stays&#46; The symptoms consistent with PTSD occur in one &#40;1&#41; out of every five &#40;5&#41; survivors of critical conditions twelve &#40;12&#41; months after their ICU stay&#44; and there is a higher prevalence in patients with a psychiatric history who experienced memories during their ICU stay and received benzodiazepines&#44; although in this last case&#44; the causal relation cannot be established&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Acute respiratory distress syndrome &#40;ARDS&#41; survivors experience frequent psychiatric disorders after their ICU stay&#46; It has been confirmed that 36 per cent&#44; 42 per cent&#44; and 24 per cent of these patients show symptoms of depression&#44; anxiety&#44; and PTSD&#44; respectively&#44; some six &#40;6&#41; months after being discharged from the hospital&#44; with minimum changes of prevalence at 12 months&#46; Being of a younger age was associated with anxiety and PTSD&#44; while longer courses of opioid treatment were associated with symptoms of depression&#44; and anxiety&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">3</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Cognitive disorders</span><p id="par0020" class="elsevierStylePara elsevierViewall">Cognitive disorders damage the executive function&#44; memory&#44; and attention&#46; The delirium is an independent risk factor for its development&#46; The global cognition and executive function assessment of one cohort of patients with acute respiratory distress&#59; cardiogenic shock&#59; or septic shock confirmed that three &#40;3&#41; months after being discharged from the hospital&#44; 40 per cent of the patients had a below average global cognitive score of 1&#46;5 standard deviations&#44; while 26 per cent of the patients had a below average global cognitive score of 2 standard deviations &#40;similar to that of patients with mild Alzheimer&#39;s disease&#41;&#46; The annual figures were 34 per cent&#44; and 24 per cent&#44; respectively&#46; Longer bouts of delirium were associated with worse cognition and executive function at 3 and 12 months&#44; respectively&#46; High doses of benzodiazepines were not associated with worse long-term cognitive scores&#44; but they were an independent risk factor of worse executive function scores at 3 months&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">4</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Physical disorders</span><p id="par0025" class="elsevierStylePara elsevierViewall">Mobility-limiting physical disorders are very common in the early stages of the post-ICU period&#46; Most patients&#44; especially those who have had long stays at the ICU&#44; are not self-sufficient patients during the first week after hospital discharge&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a> Functional independence improves with early rehabilitation programs&#44; but regaining muscle mass and strength can take weeks&#44; months or even years after hospital discharge&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">6</span></a> Recently&#44; muscle weakness measured using the Clinical Frailty Score has been associated with higher mortality rates at 3 and 12 months&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">ICU-acquired muscle weakness is a clinical diagnosis&#46; The typical presentation in the acute phase is symmetric muscle weakness that affects the limbs and respiratory muscles&#46; Terms such as polyneuropathy&#59; myopathy in critically ill patients&#59; or neuromyopathy speak to us about the underlying condition and are identified through neurophysiology or muscle biopsy&#46; Not all patients with ICU-acquired muscle weakness show polyneuropathy or critical illness myopathy&#46; Not all patients with a neurophysiological diagnosis of neuropathy or myopathy have ICU-acquired muscle weakness&#44; even though the risk of developing it is high&#46; Among the physiopathological findings&#44; the calpain and ubiquitine-proteasome mediated myofibrillar protein rupture is one of the key elements&#44; especially during the sepsis&#44; that leads to a loss of myosin filaments&#59; sarcomere disassembly&#59; and muscle dystrophy&#46; This increase in the rate of muscle protein ruptures gets worse with immobilization which&#44; to a greater or lesser extent&#44; is one of the constants of critically ill patients&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">The office of intensive outpatient care</span><p id="par0035" class="elsevierStylePara elsevierViewall">The identification and management of the PICS requires one multidisciplinary team&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Since 2009&#44; the guidelines published by the U&#46;K&#46; National Health Service through its National Institute for Health and Care Excellence recommends all its hospitals to review the provision of follow-up units for critically ill patients&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">9</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">In our country&#44; the Hospital Universitario La Paz Critical Care Medicine Department &#40;CCMD&#41; has started a program for PICS detection and follow-up&#46; Without leaving out the strategies aimed at its prevention&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> the elements of the project focus on the follow-ups conducted at the hospital floors and the check-ups conducted at the office of intensive outpatient care of patients at risk of developing PICS&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The patient at risk is assessed at the hospital floor 5&#8211;7 days after being discharged from the CCMD&#44; and should he still be eligible for assessment&#44; a new appointment is arranged three &#40;3&#41; months later at the office of intensive outpatient care&#46; The actions that will be conducted there are&#58; anamnesis from the moment of hospital discharge&#59; physical examination&#59; assessment of pulmonary function&#59; assessment of muscle strength&#59; functional assessment&#59; and quality of life&#44; psychological and cognitive assessments&#46; Based on the characteristics of the patients&#44; a new appointment will be arranged with each individual 6&#44; 9 and 12 months later or&#44; in the absence of alterations requiring further medical appointments&#44; the patient will be discharged from the hospital&#46; Additionally&#44; based on the alterations found&#44; the patients can be referred to the corresponding medical specialists &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; The CCMD teams up with the unit of psychiatry and the rehab unit for the implementation of this program&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">The conceptual changes of our medical specialty have brought the intensivist out of the CCMD&#46; Following in the footsteps of this philosophy&#44; the project aims at providing better healthcare to the critically ill patient before&#44; during&#44; and &#8220;after&#8221; the resolution of his critical condition<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">11</span></a> &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; Therefore&#44; the answer to the question posed at the beginning of this point of view letter is affirmative&#46; One multidisciplinary team coordinated by the intensivist&#44; who has been following the clinical trajectory of the patient during his stay at the CCMD&#44; is the strategy that should be followed in order to achieve the final goal of intensive medicine&#44; that is&#44; bring back the patient to his activities of daily living&#8211;both professional and socially in optimal health conditions both physically and mentally&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflict of interests</span><p id="par0060" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest whatsoever&#46;</p></span></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Extremera P&#44; A&#241;&#243;n JM&#44; Garc&#237;a de Lorenzo A&#46; &#191;Est&#225;n justificadas las consultas externas de medicina intensiva&#63; Med Intensiva&#46; 2018&#59;42&#58;110&#8211;113&#46;</p>"
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          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Model of critical condition&#46; Edited by Angus and Carlet&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">11</span></a> CCMD&#58; critical care medicine department&#46; <span class="elsevierStyleSup">a</span> Set of prevention measures &#8216;ABCDEF&#8217;&#58; &#40;A&#41; prevention and management of pain&#59; &#40;B&#41; sedative withdrawal test&#46; Spontaneous breathing trial&#59; &#40;C&#41; choice of analgesia and sedation&#59; &#40;D&#41; prevention and management of delirium&#59; &#40;E&#41; early mobilization&#59; and &#40;F&#41; involvement of the families&#46;</p>"
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          "leyenda" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">ADL&#58; Activities of daily living&#46; ARDS&#58; Acute Respiratory Distress Syndrome&#46; MODS&#58; Multiple organ dysfunction syndrome&#46; MV&#58; Mechanical ventilation&#46; PTSD&#58; Post-traumatic stress disorder&#46; CRA&#58; Cardiorespiratory arrest&#46;</p>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Complication&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Description&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Risk factors&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Natural history&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Physical function&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Impairment of ADL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Sepsis&#46; ARDS&#46; MV<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>7 days&#46; MODS&#46; Poor glucose regulation&#46; Age&#46; Vasoactive drugs&#46; Corticosteroids&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Improvement of ADL in a matter of months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pulmonary function&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Impaired spirometry&#44; lung volumes and diffusing capacity<br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Duration of MV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Usually mild during the first year&#44; but it can remain for another five years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">Psychiatric</td><td class="td" title="table-entry  " align="left" valign="top">1&#46; Depression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">Sepsis&#44; ARDS&#44; trauma&#44; hypoglycemia&#44; hypoxemia&#44; delusional memories&#46; Sedation&#44; former unemployment&#46;</td><td class="td" title="table-entry  " align="left" valign="top">1&#46; Depression&#58; It can improve during the first year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">2&#46; Anxiety&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46; Anxiety&#58; It can remain beyond the first year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">3&#46; PTSD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Women&#44; Age &#60;50 years old&#46; Alcoholism&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46; PTSD&#58; Poor improvement during the first year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="4" align="left" valign="top">Cognitive</td><td class="td" title="table-entry  " rowspan="4" align="left" valign="top">Memory disorder&#46; Attention&#46; Executive function&#46; Speed of mental processing&#46; Visual-spatial ability</td><td class="td" title="table-entry  " align="left" valign="top">Delirium&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="4" align="left" valign="top">Significant improvement during the first year&#46; Residual deficit up to six years</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sepsis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ARDS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Other &#40;glucose dysregulation&#44; duration of MV&#44; hypotension&#44; CRA&#44; &#8230;&#41;&nbsp;\t\t\t\t\t\t\n
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                      "titulo" => "Improving long-term outcomes after discharge from intensive care unit&#58; report from a stakeholders&#8217; conference"
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                          "etal" => true
                          "autores" => array:6 [
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                            2 => "H&#46; Cohen"
                            3 => "R&#46;O&#46; Hopkins"
                            4 => "C&#46; Weinert"
                            5 => "H&#46; Wunsch"
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                      "doi" => "10.1097/CCM.0b013e318232da75"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2012"
                        "volumen" => "40"
                        "paginaInicial" => "502"
                        "paginaFinal" => "509"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21946660"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0065"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Posttraumatic stress disorder in critical illness survivors&#58; a metaanalysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46;M&#46; Parker"
                            1 => "T&#46; Sricharoenchai"
                            2 => "S&#46; Raparla"
                            3 => "K&#46;W&#46; Schnek"
                            4 => "O&#46;J&#46; Bienvenu"
                            5 => "D&#46;M&#46; Needham"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/CCM.0000000000000882"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2015"
                        "volumen" => "43"
                        "paginaInicial" => "1121"
                        "paginaFinal" => "1129"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25654178"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Psychiatric symptoms in acute respiratory distress syndrome survivors&#58; a 1-year national multicenter study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Hung"
                            1 => "A&#46;M&#46; Parker"
                            2 => "O&#46;J&#46; Bienvenu"
                            3 => "V&#46;D&#46; Dinglas"
                            4 => "E&#46; Colantuoni"
                            5 => "R&#46;O&#46; Hopkins"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/CCM.0000000000001621"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2016"
                        "volumen" => "44"
                        "paginaInicial" => "954"
                        "paginaFinal" => "965"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26807686"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term cognitive impairment after critical illness"
                      "autores" => array:1 [
                        0 => array:2 [
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                          "autores" => array:6 [
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                        "link" => array:1 [
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                      "titulo" => "The ABCDEF bundle&#58; science and philosophy of how ICU liberation serves patients and families"
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                      "titulo" => "Surviving intensive care&#58; a report from the 2002 Brussels Roundtable"
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