High-pitched alarms beep sporadically. A ventilator wheezes. You have an IV line stuck in your arm, a breathing tube down your throat, and a catheter in your urethra. As a patient in a hospital intensive care unit, chances are good that you feel helpless, scared, and confused. Odds are also good, new research shows, that the ordeal could trigger mild to severe depression.

Mortality rates of critically ill patients have decreased markedly in recent years thanks to advancements in care. Given the improved survival rates of critically ill patients, investigators have broadened their focus from short-term mortality to long-term mortality and morbidities that are often under recognized by intensive care unit (ICU) practitioners. The Society of Critical Care Medicine (SCCM) has defined post–intensive care syndrome (PICS) as a new or worsening decrement in mental, cognitive, or physical health following critical illness that persists beyond the acute hospitalization. Many medication-related risk factors are associated with development of cognitive impairment in critically ill patients, including glucose dysregulation, delirium, and medications. Medications have also been associated with acute neuromuscular weakness following an ICU admission. In the past decade, the increased risk of adverse drug events (ADEs) during transitions of care has become widely known. This column focuses on how medication management strategies in the ICU, after the ICU, and after hospitalization may prevent or help manage PICS

PLATTSBURGH — There is a gap in care when people leave the ICU and return to their lives.
To help those suffering after an ICU admission, a Post Intensive Care Syndrome (PICS) Support Group was launched at the University of Vermont Health Network, Champlain Valley Physicians Hospital in Plattsburgh.