Post-traumatic stress disorder (PTSD) may develop after exposure to a life-threatening event or serious injury. Symptoms include recurring and intrusive memories, such as flashbacks, avoidance of reminders and persistent symptoms of anxiety or physiological arousal. Many factors are associated with the development of PTSD in intensive care unit (ICU) patients, including increased length of stay, and greater levels and longer duration of sedation. Patient-related factors associated with a higher risk of PTSD include younger age, female gender, previous psychological problems and recall of delusional memories from ICU. In contrast, the formation of even fragmented factual memories may reduce the risk of PTSD. Optimum, analgesia-based sedation may help patients to form factual memories of ICU, so possibly reducing the risk of PTSD. Patient diaries, written by health professionals and family members and close friends, may also support patients in coming to terms with traumatic, delusional memories, and so reduce their emotional and psychological symptoms. Following ICU discharge, validated screening tools such as ICU Memory and Post-traumatic Stress Syndrome 14-Questions Inventory can be used as part of routine follow-up to identify patients who may need referral for more specialist assessment of possible PTSD symptoms.

What is post intensive care syndrome (PICS)? Each year, approximately 800,000 patients in the United States develop an illness that results in admission to an ICU and need for mechanical ventilation. Most survive to hospital discharge. This transition, while positive, often begins a new, challenging phase of recovery. ICU survivors, particularly those who require prolonged mechanical ventilation, experience high mortality. Compromises in physical, psychological, and/or cognitive function are common. Both patients and family caregivers are at risk for symptoms of anxiety, depression, post traumatic stress disorder (PTSD), and sleep disorders. Studies suggest that as many as 40% of ICU survivors and family
members experience physical, psychological, and/or cognitive dysfunction. Termed post intensive care syndrome, this consequence is defined as “new or worsening impairment in physical, cognitive, or mental health status arising after critical illness and persisting beyond discharge from the acute care setting.”6 Both patients and family caregivers may be affected, a consequence termed PICS (patient) or PICS-F (family member) This review will discuss risk factors, clinical manifestations, and strategies for prevention and management of PICS.

Over the past several decades, advances in pediatric critical care have saved many lives. As such, contemporary care has broadened its focus to also include minimizing morbidity. Post Intensive Care Syndrome, also known as “PICS,” is a group of cognitive, physical, and mental health impairments that commonly occur in patients after ICU discharge. Post Intensive Care Syndrome has been well-conceptualized in the adult population but not in children