Post–intensive care syndrome (PICS) is a myriad of chronically debilitating symptoms, often including chronic pain, associated with prolonged ICU care. Though the exact mechanism of chronic post-ICU pain is unknown, it is postulated that the severity of inflammation associated with many forms of critical illness leads to chronic pain in patients long after resolution of their acute critical illness. Increasing emphasis on long-term outcomes of ICU survivors makes prevention of chronic pain and PICS a priority for multidisciplinary ICU teams. This article discusses the prevalence and mechanisms of chronic post-ICU pain and suggests strategies to reduce the impact of chronic pain on quality of life in ICU survivors.

Bedside rounds have evolved concurrently with hospitalist medicine and patient-centered care. Family-centered rounds are the foundation of effective communication in the in-patient pediatric setting. Participant perspectives (family members, patients, nurses, faculty, and trainees) on family-centered rounds differ and goals may not always align. Further, the practical components of how rounds are conducted varies and have continued opportunities for improvement. This article summarizes the most recent experience with rounds in an attempt to identify unified and effective strategies moving forward.

We will break our conversation about preventing Post Intensive Care Syndrome into two parts. This month in Part I, we will focus on steps that the health care team will take to prevent PICS. Next month in Part II, we will focus on preventative steps that loved ones can take.