Post-intensive care syndrome (PICS): symptoms, treatment, prevention

Post-intensive care syndrome (PICS): symptoms, treatment, prevention

Post-intensive care syndrome refers to physical, cognitive, and mental health problems that can develop after a person survives a life-threatening illness, most commonly after being discharged from the intensive care unit.

According to the American Thoracic Society, more than 50% of people who spend time in a hospital intensive care unit (ICU) develop at least one complication of post-intensive care syndrome.

These complications can affect:

  • cognitive function (thinking ability)
  • physical function
  • Mental Health

This article will take a closer look at post-intensive care syndrome, including symptoms, treatment, and general outlook.

Anyone who survives a life-threatening illness can develop post-intensive care syndrome. This includes people who were healthy before they got sick.

However, it is more likely to affect people who spend time in the intensive care unit of a hospital. The longer the stay, the higher the risk.

The risk is also higher for older people and people who have pre-existing health conditions. Spending time in intensive care can make pre-existing conditions worse or lead to new problems. This includes conditions such as:

  • lung disease
  • muscle disorders
  • dementia
  • acute brain dysfunction (due to stroke or severe alcohol use disorder)

Also, people who develop certain complications while sick are more likely to have post-intensive care syndrome. Examples of these complications may include:

Post-intensive care syndrome is different for everyone. Some people may experience one or two complications, while others may develop several. The severity can also vary.

Symptoms can appear when a person is in intensive care. But in general, the term “post-intensive care syndrome” is used to describe problems that develop after a person leaves the intensive care unit.

Additionally, 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 intensive care develop cognitive problems, such as:

  • difficulty thinking
  • memory loss
  • lack of concentration and attention
  • language issues
  • impaired visual-spatial abilities

physical function

Post-resuscitation syndrome can cause the following physical symptoms:

Mental Health

Mental health symptoms of post-intensive care syndrome can include:

Because post-intensive care syndrome can cause many different symptoms, there is no specific way to diagnose it. A doctor can diagnose the disease 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 may notice certain symptoms by talking with the person or asking how they are doing. Likewise, they can learn more about these symptoms by talking with the person’s caregiver.
  • Strength and endurance tests: These tests measure physical function. An example is a walk test.
  • Pulmonary function tests: A doctor may order a lung function test to monitor breathing.
  • Questionnaires: This is useful for monitoring a person’s mental state, physical function, and cognitive abilities after discharge from the intensive care unit.

If a healthcare professional suspects other symptoms, they may suggest additional tests and investigations.

Post-resuscitation syndrome can last from several months to several years. The exact treatment depends on the specific symptoms.

A doctor can prescribe the following therapies:

  • Physical therapy: Physical therapy, exercise, and rehabilitation can help improve weakness and other physical problems. 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 can prescribe medication in some cases.
  • Occupational therapy: Occupational therapy can help people manage new symptoms and make daily activities easier.
  • Neurocognitive processing: For cognitive problems, a specialist called a neurologist can perform an assessment and offer specific treatment.

Loved ones and caregivers of someone with post-intensive care syndrome may also need their own treatment and support. This may include therapy to manage issues such as anxiety, depression, and grief.

There are ways to reduce the risk and severity of post-resuscitation syndrome. The researchers suggest that medical professionals follow specific guidelines which aim to:

  • minimize the duration of use of a mechanical ventilator
  • limit sedatives as much as possible
  • start physiotherapy early
  • encourage movement
  • allow friends and family to visit
  • communicate with and engage friends and family
  • monitor delirium and other mental health issues

Generally, symptoms of post-resuscitation syndrome last from 6 months to 1 year. The recovery process will be different for each person.

Some symptoms may go away on their own within a few weeks. Other symptoms may take months or years to improve. In some cases, symptoms may persist for several years.

If symptoms persist, it may be difficult for a person to return to work or be able to afford therapy. This can greatly affect their quality of life.

Post-intensive care syndrome is a group of physical, cognitive, and mental health problems that can occur after a serious illness. It is more common in people who spend time in intensive care or who have pre-existing health conditions.

Symptoms of post-intensive care syndrome can vary in type and severity. Some symptoms may only last a few weeks, while others may 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.

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