after the ICU

In 2010, the Society of Critical Care Medicine (SCCM) grouped these post-ICU health issues into what is now known as postintensive care syndrome, or PICS. Risk factors that increase the chances of PICS include heavy sedation, delirium, acute respiratory distress, immobility, sepsis and hypoglycemia.

“The perfect scenario for PICS is mechanical respiration, sedation, being bedridden and infections,” says Dr. Joseph Philip, a University of Florida Health pediatrician certified in pediatric critical care medicine. “The severity of illness and the number of medical interventions raise the risk.”

PICS symptoms are divided into three main categories:

COGNITIVE: According to a 2013 study published in the New England Journal of Medicine, 58 percent of ICU patients who entered the hospital with normal brain function had cognitive impairments a year after discharge. Cognitive problems can include memory loss, di culty making decisions, slower processing speed and reduced attention and ability to concentrate. According to the SCCM, some people improve during the first year after discharge, but others may never fully recover.

PHYSICAL: According to the SCCM, ICU-acquired muscle weakness occurs in up to 50 percent of patients who stay in the ICU for at least one week. The condition makes normal daily activities, such as walking, bathing, dressing, grooming and eating, di cult. It may take more than a year to fully recover from ICU-acquired muscle weakness. Other physical problems linked to PICS include slower movement and multiple falls.

EMOTIONAL: These problems may include depression, anxiety and post-traumatic stress disorder. A recent Johns Hopkins University of Medicine study showed that 20 percent of all ICU patients su er from post-traumatic stress disorder, which can include severe anxiety and flashbacks.

How To Help

“Even while the patient is in ICU, there are things we can do to alleviate PICS,” says Philip. “Doing physical therapy with a therapist and having family members have normal conversations or read to them. Setting up a routine day-night cycle while they are in the hospital helps with their emotional well-being, too.”

Once the patient is discharged, Philip says, “Patient and family members should be vigilant about PICS symptoms and stay in close contact with their primary care physician. Physical therapy, meds and cognitive therapy are some of the treatments. And it should be noted that even family caregivers can su er PICS, so they should seek help if needed, too.”