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At least half of all patients who survive treatment in an intensive care unit will experience at least one of a triad of problems associated with post-intensive care syndrome, or PICS, and this may be true for people recovering from COVID-19 following ICU care. PICS can manifest as problems with physical function, cognition and mental health, according to a fact sheet from the American Thoracic Society. PICS is a relatively under-recognized issue, despite the fact that it affects a large number of people treated in an ICU, according to Patricia Ohtake, associate professor in the physical therapy program, School of Public Health and Health Professions.

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Post-intensive care syndrome (PICS) is a collection of symptoms, limitations, and impairments that are present in people who have recently been treated in a hospital’s intensive care unit (ICU). These impairments may be chronic and may limit your full participation in your normal activities upon discharge from the ICU. If you have been recently discharged from the intensive care unit, you may benefit from the care of a physical therapist to help you recover fully and return to your previous level of work and recreational activity.

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Even healthcare professionals may not be aware and prepared for a condition called Post-ICU Syndrome (PICS) that can occur in the aftermath of COVID-19. What about those who were hospitalized for COVID-19, treated in ICU, and are unaware of the possible long-term impact and rehabilitation phase? There is a tendency to think that once the patient is discharged from the hospital, has tested negative, and looks well, the problem is resolved. However, the struggle of COVID-19 survivors and family members or caregivers may not end there.

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Definition of post-intensive care unit syndrome (PICS) and post-intensive care unit syndrome-family (PICS-F).

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The one pager explains the effect of post intensive care syndrome (PICS) on the ICU patients and their families.

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The objective of this power point is to: Define Post-intensive care Syndrome (PICS), Associated risk factor, and long-term consequences; recognize available resources to address PICS through education, therapy, and support groups; and integrate knowledge into practice to guide at risk patient/families toward available resources.

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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.

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While the short-term outcomes of ICU patients have dramatically improved over the last half-century, it is increasingly recognized that many ICU survivors experience declines in physical and cognitive functioning that persist well beyond their acute hospitalization. Psychiatric sequelae, including anxiety, depression, and post-traumatic stress disorder (PTSD) are also prevalent among both ICU survivors and their family members. Attendees of a 2010 meeting of the Society of Critical Care Medicine coined the term Post Intensive Care Syndrome (PICS) to describe new and persistent declines in physical, cognitive, and mental health functioning that follow an ICU stay and for which other causes, such as traumatic brain injury (TBI) or cerebrovascular accident (CVA), have been excluded. The term PICS-F is applied to the close family members of ICU patients who experience subsequent adverse mental health outcomes, the most common of which are sleep deprivation, anxiety, depression, and complicated grief.

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Aim: In this review, we sought to succinctly review what Post intensive care syndrome is, it’s risk factors, consequences, assessment, diagnosis, prevention and treatment among family members of intensive care patients.

Background: The proportion of family members caring for a patient in intensive care units is expected to proportionally increase with increase in utilization of intensive care units due to various reasons. Subsequently, unfavorable physical, psycho-social responses due to exposure to complications following admission of a family member in intensive care due to critical illness will consequently increase among family members. These unfavorable family responses to critical illness have been termed “Post intensive care syndrome-family (PICS-F).” Post intensive care syndrome-family encompasses: anxiety, acute stress disorder, post-traumatic stress, depression, and complicated grief. Healthcare providers as well as family members need to be knowledgeable on the extent, diagnosis, prevention, and outcomes of these sequelae. Relationship to the patient, younger patients, prior experience of ICU, low economic status, length of ICU stay, unmet self-care, communication needs and distance from the hospital seem to predispose family members to PICS-F. Longer distance from hospital and higher resilience seem to protect family members from PICS-F. Prevention of PICS-F includes: effective family-ICU staff communication, enhancing resilience and coping, post discharge planning and follow-up interventions.

Conclusion: results highlight the importance of acknowledging experiences of family members having a patient admitted in intensive care unit. Healthcare professionals need to have insights into this phenomenon and optimally intervene to prevent these physiological and psycho-social sequelae.

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As ICU mortality decreases, post-ICU morbidity has been reported in over 50% of ICU survivors. Hallmark features of post-ICU morbidity are the new or worsened functioning in one or more of the following domains after critical illness: Physical, Cognitive, Psychological.

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Post-sepsis syndrome is a condition that affects up to 50% of sepsis survivors. It includes physical and/or psychological long-term effects.