Care Syndrome (PICS) is a condition that occurs when the patient is
in the ICU, but continues
even after the patient returns home.
- PICS may involve body, mind, thoughts or feelings of
the patient and may even affect family members.
- Nearly 80% of patients admitted to the ICU develop cognitive problems like thinking ability and
memory lapses that last, sometimes, even for years.
Intensive Care Unit is a medically controlled environment that is designed to
support the medical needs of a patient, to improve lifespan and also to improve the quality of a patient's life. The patient-centric measures that have been devised for supporting a patient's medical
condition lead to effects that last for a few months or even years after the
patient had been discharged from the ICU.
to the Society of Critical Care at The Johns
- Post-traumatic Stress Syndrome is witnessed among one in three patients who require the support of a breathing machine.
- An ICU stay has been found to increase depression in 50% of patients.
- Muscle weakness due to ICU care occurs among
- 50% of patients undergoing treatment for sepsis.
- 50% of patients with a stay in the ICU that lasts longer than 7 days.
- 33% of patients who require the support of a ventilator.
muscle weakness can last longer than a year in many instances.
ill patients who are admitted to the ICU and are
forced to receive treatment for a period of time in this medically monitored
system are at an increased risk for the following conditions:
- Prolonged necessity for organ support
- Deficit in concentration
- Increased time required to process information
- Lowered visual spatial resolution
- Post-traumatic stress disorder
- Lowered ability to complete tasks
- Memory lapses
Even 1 to 5 years after being discharged from an ICU, the patient may suffer from:
- Difficulty in movement
- Lack of social skills
- Increased risk for falls
- 34% show a decline in cognitive ability
The post-ICU syndrome includes physical, psychological and neurological symptoms that affect individuals who have stayed in the ICU for long periods of time. Patients suffering from sepsis
, which is a stage of infection that is called 'blood poisoning', are at a higher risk of developing ICU-induced delirium
, though other ICU patients may also develop this condition.
is a state of confusion when a person is unable to think clearly and process information. The patient may also 'see' things that are not there or experience
situations that do not actually occur.
‘Quality of life should be the focus when opting for interventional strategies in an ICU.’
may be caused by:
- A lack of oxygen to the brain
- Being on ventilator support for long periods
- Severe pain
a large number of patients who undergo treatment for sepsis in an ICU develop
delirium, doctors are now treating this condition more aggressively, to lower
the period of stay in an ICU. Pro-active steps are being taken to ensure that
the patient is dependent on the ventilator for fewer periods with active
support to get the patient walking soon after treatment. The dosages of
medications are also checked routinely to lower incidences of drug-induced delirium.
Patients who remain in the ICU for long periods of time are prone to returning home and gaining weight with little movement due to increased family support and care. This increases their time of recovery and leads to many disabilities. Post-ICU syndrome can be effectively treated by including family members in the active rehabilitation
the patient by encouraging recovery through careful mobilization of the patient.
than 80% of patients suffer from depression, either due to disability induced
by their condition or due to perceived disability. Psychological support from
trained professionals will aid such patients in leading a more normal
with Post-ICU Syndrome
a Brazilian study that focused on patients receiving treatment at a single center, 690 patients discharged after receiving treatment in the ICU were
- 27% of the patients died
- 18% were readmitted into the ICU
- 40% were readmitted to the hospital
- 52% required at least a single emergency visit to the hospital
- 11% of the patients required psychological counseling or support
risk of death among patients who received treatment in the ICU was associated
with severity of organ dysfunction and severity of post-ICU syndrome rather than the underlying disease condition that required
Study of Pneumonia Patients Treated in ICUs
An Australian cohort study examined the effects of treatment received in an ICU among patients suffering from severe Influenza (H1N1) pneumonia
and with a mean age of 36 years. These patients required Extracorporeal Respiratory Support (ECMO- Extracorporeal Membrane Oxygenation) for a median number of 11 days. This study highlighted that though 85% of patients survived, only 26% of patients returned to work after a period of 8 months while the others suffered from ICU-induced disabilities.
increased disabilities associated with post-ICU syndrome warrant better management of patients in the ICU set up with:
- Fewer interventions
- Lower dosage of drugs
- Reduced period on ventilators
- Better communication between doctors and families regarding the aim of the treatment
- Reduced period of time before mobility is encouraged
- Pro-active psychological support
in medical care have increased the lifespan of people, even patients admitted
with severe medical complications that include patients suffering from certain
forms of cancer, old and frail patients, patients with severe sepsis and
cardiac patients. The post-ICU quality of life led by these patients, however,
is compromised. Active monitoring of treatment mediated to patients and a
practical assessment of their need and their ability to endure the treatment
will aid in improving the lifespan of patients with a focus on the
quality of their life.
- Exploring the scope of post-intensive care syndrome therapy and care
- My (critically ill) patient has only a pneumonia" - the risk of oversimplification and the evidence of post-ICU syndrome
- ICU Delirium: Information for Patients and Families