What is PICS?
Post Intensive Care Syndrome (PICS) is defined as new or worse health problems after critical illness. These problems can affect your mind, body, thoughts, and/or feelings.
What are the risk factors?
The risk factors for developing PICS have yet to be fully defined. At this time, illness requiring admission to an Intensive Care Unit (ICU) and development of delirium during the ICU stay are the two risk factors most closely associated with risk for developing PICS. Other risk factors thought to contribute to the development of PICS include: mechanical ventilation during the ICU stay, older age, ICU stay >48 hours, a diagnosis of sepsis, and use of sedative medications. As our overall knowledge of PICS expands, so will our understanding of what places our patients at risk for this syndrome
How is PICS diagnosed?
There is no one specific test used to diagnose PICS. This syndrome is diagnosed based on the patient’s history of critical illness and the development of new or worsening impairments of cognitive, mental, and/or physical functioning following the critical illness. Because this syndrome typically develops following discharge from the ICU, it is usually recognized by non-ICU healthcare providers and/or the patient’s primary care provider. However, because PICS is a fairly newly identified syndrome, it may be that the patient and/or family members recognize the signs and symptoms of PICS first.
What are the signs and symptoms of PICS?
As the definition of PICS highlights, this syndrome can affect one or several aspects of a person’s life. The mental, physical, and cognitive affects are highlighted below. However, keep in mind that this list is not exhaustive and any new or worsening symptoms should be considered potential signs and symptoms of PICS.
- Body: Muscles weakness, difficulty with balance
- Thoughts/Feelings: Anxiety, depression, sleep disturbance, nightmares
- Mind: Problems with thinking, problems with memory, difficulty concentrating, difficulty completing daily tasks
How is PICS prevented?
Our knowledge of PICS is rapidly developing and changing, therefore we have yet to fully understand how to prevent this syndrome. This is a topic of much discussion and research in the medical community. Efforts are being focused on limiting the negative affects of various therapies commonly used to care for patients in the ICU during critical illness. This includes but is not limited to ICU interventions such as:
- Ensuring quality sleep
- Preventing the development of delirium
- Limiting the amount of medications used to sedate patients
- Limiting the need for and length of mechanical ventilation
- Getting patients up, out of bed, and mobile as early as possible during their ICU stay
- Encouraging daily journaling while in the ICU by patients, caregivers, and/or family
What can be done to treat PICS?
Treatment of PICS depends on the area of function affected by the condition. Discussion with the patient and family during hospitalization can help identify potential problems early. ICU follow up may also play a vital role in identifying Appropriate post-ICU experts may be needed to provide support.