In the United States, nearly 27% of hospital admissions involve the use of intensive care unit (ICU) services. Due to advancements in acute care, survival rates have increased among patients admitted to the ICU. However, these individuals are at high risk for mortality and readmission following discharge, along with numerous long-term challenges that are collectively referred to as post-intensive care syndrome (PICS).

Over the past decade, survival from critical illness has dramatically increased due to a better understanding of the pathophysiological mechanisms of disease, improved treatment strategies and advancements in medical technology. Several studies have shown improved survival and long-term outcomes in survivors of critically illness. However, surviving the intensive care unit (ICU) stay is just the start of a long road to recovery for a majority of these patients. The discharge from the ICU opens the path to a long journey of challenging physical rehabilitation, mood disorders, cognitive impairment, psychological distress, financial hardship, and caregiver burden and burnout.
In recent years there has been a growing recognition of impairments that affect the physical, psychological, social, and emotional aspects of the individual after ICU discharge that may adversely impact daily functioning and quality of life (QOL). Recently, the term “post-intensive care syndrome” (PICS) is used to describe any new or worsening impairments in physical, cognitive, or mental health status arising after critical illness and persisting beyond the acute care hospitalization.1 PICS may persist for months to years after hospital discharge. Most impairments will diminish with time but some may linger on until the patient’s actual demise. This chapter will explore in detail the different domains affected in PICS, its impact on the individual and society, and offer insights into future developments.

Imagine being told you have been diagnosed with a life-altering illness and as a result, will need to deliver your baby prematurely, or that your son or daughter was involved in a car crash and has suffered severe head trauma, or your significant other needs open heart surgery after a positive stress test. There is no doubt you and your family will experience feelings of great anxiety, fear, and sadness. Each of these experiences may lead to an intensive care unit (ICU) admission for your loved one. An ICU stay will further exacerbate these overwhelming emotions and leave you emotionally and mentally changed.
According to Davidson, Jones, and Bienvenu (2012), one-third of parents with a child in the ICU have clinically significant symptoms of acute stress disorder. Additionally, 40% of relatives with loved ones who are critically ill suffer from anxiety. Depression, anxiety, and post-traumatic stress disorder (PTSD) are found to be at the highest levels in families of patients in the ICU (Jones, Backman, & Griffiths, 2012).