Post Intensive Care Syndrome (PICS): an overview of the definition, etiology, risk factors, and possible counseling and treatment strategies

ABSTRACT

Introduction

Post-intensive care syndrome (PICS) has only recently been recognized as a new clinical entity in patients surviving their intensive care unit (ICU) stay due to critical illness. With increasing survival rates of ICU patients worldwide, there is a rising interest regarding post-ICU recovery.

Areas covered

First, based on the current literature a definition is provided of PICS, including the domains of impairments that comprise PICS along with the etiology and risk factors. Second, preventive measures and possible treatment strategies integrated in the follow-up care are described. Third, the authors will discuss the current SARS-Cov-2 pandemic and the increased risk of PICS in these post-ICU patients and their families.

Expert opinion

PICS is a relatively new entity, which not only encompasses various physical, cognitive, and psychological impairments but also impacts global health due to long-lasting detrimental socioeconomic burdens. Importantly, PICS also relates to caregivers of post-ICU patients. Strategies to reduce this burden will not only be needed within the ICU setting but will also have to take place in an interdisciplinary, multifaceted approach in primary care settings. Additionally, the SARS-Cov-2 pandemic has a high burden on post-ICU patients and their relatives.

KEYWORDS:

• Post-intensive care syndrome
• family
• PICS
• PICS-F
• risk factors
• ICU survivors
• psychosomatic impairments
• SARS-Cov-2
• Covid-19

Article highlights

• The post-intensive care syndrome (PICS), a relatively new and complex syndrome, is a rising global health problem, which up to now still lacks a clear definition and diagnostic criteria.

• Implementing integrative prevention plans, such as the ABCDEF bundle with changes in drug regimen and early mobilization, could reduce the long-term complications of PICS.

• Structured follow-up programs should not be limited to hospital care but rather be combined with primary care follow-up plans for an interprofessional approach.

• Patients surviving severe SARS-Cov-2 infection and their relatives have an increased risk of developing PICS with symptoms in all domains it encompasses.

• Technology-based platforms (e.g., telephones, digital tablets), providing information and support implemented into intervention plans could benefit this patient population and their relatives in the long term and is in line with the rapidly growing digital developments in the medical world.

Reviewer disclosures

Peer reviewers of this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.