Post Intensive Care Syndrome PICS Symptoms Treatment Prevention

Post Intensive Care Syndrome PICS Symptoms Treatment Prevention

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What Is Post-Intensive Care Syndrome

Medically reviewed by Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT — By Kirsten Nunez on October 25, 2022Post-intensive care syndrome refers to physical, cognitive, and mental health issues that can develop after a person has survived a life threatening illness, most often after being discharged from the ICU. According to the American Thoracic Society, more than 50% of people who spend time in a hospital’s intensive care unit (ICU) develop at least one complication of post-intensive care syndrome. These complications may affect:cognitive function (thinking ability)physical functionmental health This article will take a closer look at post-intensive care syndrome, including the symptoms, treatment, and overall outlook.

Who gets post-intensive care syndrome

Any person who survives a life threatening illness can develop post-intensive care syndrome. This includes people who were healthy before they got sick. However, it’s more likely to affect people who spend time in a hospital’s ICU. The longer the stay, the higher the risk. The risk is also higher for people who are older and people who have preexisting health conditions. Spending time in the ICU may worsen preexisting conditions or lead to new issues. This includes conditions like:lung diseasemuscle disordersdementiaacute brain dysfunction (from stroke or severe alcohol use disorder) Additionally, people who develop certain complications while they’re sick are more likely to have post-intensive care syndrome. Examples of these complications can include:severe infectionslow or high blood glucoselow blood oxygen levels (hypoxemia)low blood pressure (hypotension)sedationacute respiratory distress syndromedeliriumprolonged mechanical ventilationmulti-organ failureexposure to systemic corticosteroidssepsis

What are the symptoms of post-intensive care syndrome

Post-intensive care syndrome is different for everyone. Some people may experience one or two complications, while others might develop many. The severity can also vary. The symptoms can appear while a person is in the ICU. But in general, the term “post-intensive care syndrome” is used to describe issues that develop after a person leaves the ICU. Additionally, the symptoms fall into different categories, such as physical and cognitive function and mental health. A person can have any combination of these symptoms. Let’s look at each category in a bit more detail.

Cognitive function

More than 25% of people who stay in the ICU develop cognitive issues, such as:difficulty thinkingmemory losspoor concentration and attentionlanguage issuesimpaired visual-spatial abilities

Physical function

Post-intensive care syndrome may cause the following physical symptoms:fatigueneuromuscular weaknesspainshortness of breathdifficulty moving or exercisingimpaired lung functionsexual dysfunction

Mental health

Mental health symptoms of post-intensive care syndrome can include:anxietyirritabilitydepressiontrouble sleepingpost-traumatic stress disorder (PTSD)

How is it diagnosed

Because post-intensive care syndrome can cause so many different symptoms, there’s no specific way to diagnose it. A doctor may diagnose the condition in the hospital or after a person has left the hospital. Doctors can diagnose post-intensive care syndrome using a combination of:Observation: A doctor might notice certain symptoms by talking with the person or asking how they are. Similarly, they may learn about these symptoms by talking with the person’s caregiver.Strength and endurance tests: These tests measure physical function. One example is a walking test.Lung function tests: A doctor may request a lung function test to monitor breathing.Questionnaires: This is helpful for monitoring a person’s mental status, physical function, and cognitive abilities after they’re discharged from the ICU. If a healthcare professional suspects other symptoms, they might suggest additional tests and exams.

How is post-intensive care syndrome treated

Post-intensive care syndrome can last for several months to years. The exact treatment depends on the specific symptoms. A doctor may prescribe the following therapies:Physical therapy: Physical therapy, exercise, and rehabilitation can help improve weakness and other physical issues. This treatment usually lasts 6 to 12 weeks.Psychological and behavioral therapy: This type of therapy can help mental health issues like anxiety and depression. A doctor may prescribe medications in certain cases. Occupational therapy: Occupational therapy can help people manage their new symptoms and make daily activities easier.Neurocognitive treatment: For cognitive issues, a specialist called a neurologist can perform an evaluation and suggest specific treatment. Loved ones and caregivers of a person with post-intensive care syndrome might also need their own treatment and support. This can include therapy for managing issues such as anxiety, depression, and grief.

How can post-intensive care syndrome be prevented

There are ways to reduce the risk and severity of post-intensive care syndrome. Researchers suggest that healthcare professionals follow specific guidelines that aim to: minimize how long a person uses a mechanical ventilatorlimit sedatives as much as possiblestart physical therapy earlyencourage movementallow friends and family to visit communicate with and engage friends and familymonitor for delirium and other mental health issues

What s the outlook for people with post-intensive care syndrome

Generally, symptoms of post-intensive care syndrome last for 6 months to 1 year. The recovery process will look different for each person. Some symptoms might go away on their own within a few weeks. Other symptoms may take months or years to improve. In certain cases, symptoms may continue for several years. If symptoms persist, it may be difficult for a person to return to work or be able to pay for therapy. This can greatly affect their quality of life.

Resources for post-intensive care syndrome

Fortunately, there are resources for patients, families, and caregivers. Some hospitals have post-ICU clinics that provide counseling and support. You can also ask healthcare staff about peer support groups for post-intensive care syndrome. An initiative known as THRIVE from the Society of Critical Care Medicine offers helpful resources for people who have spent time in the ICU, as well as their families, related to post-intensive care syndrome.

The bottom line

Post-intensive care syndrome is a group of physical, cognitive, and mental health issues that can occur after a severe illness. It’s most common in people who spend time in the ICU or have preexisting health conditions. The symptoms of post-intensive care syndrome can vary in type and severity. Some symptoms may only last for a few weeks, while other symptoms can last for years. Treatment often includes physical, behavioral, psychological, and occupational therapy. Patients, family members, and caregivers can get the support they need by working with healthcare professionals. Some hospitals may provide additional resources through post-ICU clinics. Last medically reviewed on October 25, 2022

How we vetted this article

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Colbenson GA, et al. (2019). Post-intensive care syndrome: Impact, prevention, and management.
ncbi.nlm.nih.gov/pmc/articles/PMC6544795/Inoue S, et al. (2019). Post-intensive care syndrome: Its pathophysiology, prevention, and future directions.
onlinelibrary.wiley.com/doi/full/10.1002/ams2.415Rawal G, et al. (2017). Post-intensive care syndrome: An overview.
ncbi.nlm.nih.gov/pmc/articles/PMC5506407/Vrettou CS, et al. (2022). Post-intensive care syndrome in survivors from critical illness including COVID-19: A narrative review.
mdpi.com/2075-1729/12/1/107/htmWhat is post intensive care syndrome? (2020).
thoracic.org/patients/patient-resources/resources/post-intensive-care-syndrome.pdfOur experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Current Version Oct 25, 2022 By Kirsten Nunez Edited By Rosalie Rung Medically Reviewed By Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT Copy Edited By Sara Giusti Share this articleMedically reviewed by Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT — By Kirsten Nunez on October 25, 2022

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