- Post-intensive 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.
According to the Society of Critical Care at The Johns Hopkins University:
- 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.
Post-ICU SyndromeCritically 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
- Difficulty in movement
- Lack of social skills
- Increased risk for falls
- 34% show a decline in cognitive ability
ICU-induced DeliriumDelirium 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.’
AdvertisementDelirium may be caused by:
- A lack of oxygen to the brain
- Being on ventilator support for long periods
- Severe pain
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 of the patient by encouraging recovery through careful mobilization of the patient.
More 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 lifestyle.
Studies Associated with Post-ICU SyndromeIn a Brazilian study that focused on patients receiving treatment at a single center, 690 patients discharged after receiving treatment in the ICU were studied.
- 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
Australian Cohort Study of Pneumonia Patients Treated in ICUsAn 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.
The 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
- 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