Brief description of media:

Expanding elderly populations are a major social challenge in advanced countries worldwide and have led to a rapid increase in the number of elderly patients in intensive care units (ICUs). Innovative advances in medical technology have enabled lifesaving of patients in ICUs, but there remain various problems to improve their long-term prognoses. Post-intensive care syndrome (PICS) refers to physical, cognition, and mental impairments that occur during ICU stay, after ICU discharge or hospital discharge, as well as the long-term prognosis of ICU patients. Its concept also applies to pediatric patients (PICS-p) and the mental status of their family (PICS-F). Intensive care unit-acquired weakness, a syndrome characterized by acute symmetrical limb muscle weakness after ICU admission, belongs to physical impairments in three domains of PICS. Prevention of PICS requires performance of the ABCDEFGH bundle, which incorporates the prevention of delirium, early rehabilitation, family intervention, and follow-up from the time of ICU admission to the time of discharge. Diary, nutrition, nursing care, and environmental management for healing are also important in the prevention of PICS. This review outlines the pathophysiology, prevention, and future directions of PICS.

Brief description of media:

Expanding elderly populations are a major social challenge in advanced countries worldwide and have led to a rapid increase in the number of elderly patients in intensive care units (ICUs). Innovative advances in medical technology have enabled lifesaving of patients in ICUs, but there remain various problems to improve their long-term prognoses.
Post-intensive care syndrome (PICS) refers to physical, cognition, and mental impairments that occur during ICU stay, after ICU discharge or hospital discharge, as well as the long-term prognosis of ICU patients. Its concept also applies to pediatric patients (PICS-p) and the mental status of their family (PICS-F). Intensive care unit-acquired weakness, a syndrome characterized by acute symmetrical limb muscle weakness after ICU admission, belongs to physical impairments in three domains of PICS.
Prevention of PICS requires performance of the ABCDEFGH bundle, which incorporates the prevention of delirium, early rehabilitation, family intervention, and follow-up from the time of ICU admission to the time of discharge. Diary, nutrition, nursing care, and environmental management for healing are also important in the prevention of PICS. This review outlines the pathophysiology, prevention, and future directions of PICS.

Brief description of media:

Post-intensive care syndrome (PICS) is a rapidly growing phenomenon in older adults. As survival rates from ICU hospitalizations have increased over the past few decades, the long-term cognitive, psychological, and physical sequelae of the illness have become a major challenge in critical care medicine. More than half of all ICU survivors suffer from at least one PICS-related impairment, and these effects can persist as long as 5 or more years. PICS has become an increasingly important phenomenon in older adults for several reasons. First, the number of older adults with critical illness is rapidly increasing as the population ages and now accounts for about 50% of ICU admissions. Second, more than 70% of older adults hospitalized in the ICU develop delirium, which is a major risk factor for ICU-acquired cognitive impairments. Third, cognitive and functional impairment before an ICU hospitalization increases the likelihood of cognitive and functional decline afterward.

Brief description of media:

Medical advances over the past few decades have led to an overall decrease in patient mortality for those experiencing a traumatic health challenge. Research on long-term health outcomes post-traumatic illness has shown there is an increase and worsening of functional morbidity resulting from the critical illnesses and associated therapies and treatments experienced by patients. Pollack et al.(2014) estimates morbidity (the rate of ongoing clinical health challenges) to be as high as4.8%, twice the rate of mortality. Preventing or reducing mortality is no longer the sole outcome measure for effectiveness of critical care interventions(Herrup et al.,2017). Rather, ensuring optimal long-term health outcomes post-trauma are a major focus of current healthcare interventions in the intensive care unit (ICU).

Brief description of media:

Wang et al.’s review of the Post-Intensive Care Syndrome (PICS) accomplishes three goals: it describes PICS as an enormous public health problem with far-reaching consequences; it summarizes gaps in knowledge about functional impairments in PICS; and it envisions the role of geriatric psychiatry in clinical care and research to improve patient and family outcomes in PICS.

Brief description of media:

Wang et al.’s review of the Post-Intensive Care Syndrome (PICS) accomplishes three goals:1) it describes PICS as an enormous public health problem with far-reaching consequences; 2) it summarizes gaps in knowledge about functional impairments in PICS; and 3) it envisions the role of geriatric psychiatry in clinical care and research to improve patient and family outcomes in PICS.

Brief description of media:

When a COVID-19 survivor leaves the hospital, recovering physically may not be the only feat they’re faced with overcoming. For many patients who have undergone intensive care, studies have shown that there is also a likelihood for cognitive and psychological complications, which can linger for months, or even years.

Brief description of media:

The number of ICU patients admitted annually continues to grow, with most recent estimates reaching 5.7 million. As there are growing numbers of critically ill patients, sepsis survivorship also has grown as a substantial public health concern, with a significant number of survivors diagnosed with post-intensive care syndrome (PICS). PICS is defined as a new or worsening impairment in mental, cognitive, or physical health status after critical illness and lasting beyond hospitalization for acute care. It is important to go beyond saving lives in the ICU and devote additional time and attention to preventing and treating the psychiatric, cognitive, and physical sequalae of ICU illness in the follow-up setting.

Brief description of media:

PICS isn’t just an ICU issue. As a nurse, you can make a positive impact in various settings throughout the continuum of care. The strongest evidence to date supports that, for families of ICU patients, communication and information help minimize adverse outcomes. What caregivers say, how they say it, how soon, how often, and how it’s perceived by patients and families are factors that have been studied and seem to affect long-term consequences of critical illness. Early mobility is known to minimize both physical problems and delirium in ICU patients.

Brief description of media:

My family and I have needed counseling for psychological trauma stemming from my ICU experience. It wasn’t the car accident itself (which I don’t remember) that caused my post-intensive care syndrome (PICS). It wasn’t even the risk of death, which I overcame. It was the fear I felt in the ICU that created the horrible memories I’ve had such trouble dealing with.

Brief description of media:

At least one-third of ICU patients and their families experience PICS or PICS-F. Incidence is at least 50% among patients who’ve had sepsis or acute respiratory distress syndrome or were on a mechanical ventilator for more than 5 days. At least half of PICS patients still need some form of care 1 year after hospital discharge. The past decade has seen a tremendous increase in our understanding of the long-term effects of critical illness on patients and their families. As our PICS knowledge base continues to expand, the challenge is to inform healthcare providers who care for critically ill patients during and after their hospital stay of the potential consequences of ICU admission.

Brief description of media:

At least one-third of ICU patients and their families experience PICS or PICS-F. Incidence is at least 50% among patients who’ve had sepsis or acute respiratory distress syndrome or were on a mechanical ventilator for more than 5 days. At least half of PICS patients still need some form of care 1 year after hospital discharge. The past decade has seen a tremendous increase in our understanding of the long-term effects of critical illness on patients and their families. As our PICS knowledge base continues to expand, the challenge is to inform healthcare providers who care for critically ill patients during and after their hospital stay of the potential consequences of ICU admission.