What is post intensive care syndrome (PICS)?

Post-intensive care syndrome (PICS) is a collection of physical, mental and emotional symptoms that continue to persist after a patient leaves the intensive care unit (ICU).

Because of the advances in medicine over the last several decades, more people now survive critical illnesses. Clinicians used to focus more on the immediate short-term outcomes of these patients. More recently, medical professionals have shifted their attention to the long-term outcomes of survivors of critical illnesses. What they discovered is that although ICU survival improved, patients did not return to their former level of function for weeks, months and even years. Patients developed mind, body and emotional symptoms related to their critical illness and treatment in the ICU.

Who gets post-intensive care syndrome (PICS)?

Anyone who survives a critical illness that warranted admission to an intensive care unit (ICU) is susceptible to developing post-intensive care syndrome (PICS).

In addition to the critically ill ICU survivor, the family and loved ones (“the caregivers”) who provide the needed care and support can also develop some of the same mental and emotional symptoms of PICS. This condition is called PICS-family (PICS-F).

PICS impacts the quality of life of both the patient and family.

What are the symptoms of post-intensive care syndrome (PICS)?

Patients with PICS may have new or worsening brain (cognitive), emotional and/or physical symptoms. The symptoms start after the critical illness, persist after discharge from the ICU and can last for weeks, months and even years.

Brain (cognitive) symptoms:

  • Decreased memory, thinking problems
  • Difficulty talking
  • Forgetfulness
  • Poor concentration
  • Trouble organizing and problem solving

Emotional symptoms:

Physical symptoms:

  • Muscle weakness
  • Fatigue
  • Decreased mobility
  • Difficulty breathing
  • Insomnia

Symptoms of PICS-F in caregivers may include:

  • Anxiety and/or depression
  • Feeling overwhelmed
  • Stress
  • Post-traumatic stress disorder
  • Grief
  • Changes in sleep

What causes post-intensive care syndrome (PICS)?

Post-intensive care syndrome (PICS) results from the combination of factors. Care in the ICU can be intense due to the serious medical conditions themselves (such as respiratory failure, sepsis); use of life-sustaining equipment (such as endotracheal tubes, mechanical ventilators); and use of sedative, pain and other medications that have mind-altering (including delusional) effects. Patient exposure to all of these unique stressors can affect many aspects of the ICU survivor’s life.

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