Description
Post-ICU Syndrome is a condition that affects individuals who have been discharged from an intensive care unit (ICU). Physical Symptoms may include muscle weakness, fatigue, mobility issues, and difficulties with activities of daily living. Many individuals experience memory problems, difficulties with concentration, and other cognitive issues. This is often referred to as "ICU-related delirium." Anxiety, depression, and post-traumatic stress disorder (PTSD) are common psychological issues that can result from the ICU experience. Prolonged ICU stay, use of sedatives and medications, mechanical ventilation, and underlying health conditions can increase the risk of developing Post-ICU Syndrome. Physical and occupational therapy are often essential components of recovery to regain strength and function.
Summary Listen
- Post-Intensive Care Syndrome (PICS) involves new or worsened physical, cognitive, or mental health impairments after a critical illness, persisting beyond discharge. It affects cognition (25-80%), psychological health (25-80%), and physical function.
- Common mental health issues include depression, anxiety, PTSD, cognitive decline, and sleep disturbances. Physical problems involve malnutrition, reduced lung volumes, joint contractures, chronic pain, mobility difficulties, muscle wasting, and weakness. Long COVID symptoms overlap significantly with PICS.
- Family members can also experience Post-Intensive Care Syndrome for the Family (PICS-F), characterized by sleep deprivation, anxiety, depression, and PTSD. Risk factors include poor communication from medical staff, decision-making burdens, and lower educational levels.
- Cognitive impairment risk factors include delirium, brain dysfunction, substance abuse, hypoxia, hypotension, glucose dysregulation, prolonged mechanical ventilation, and renal replacement therapy. Impairments manifest as deficits in memory, information processing, and attention span.
- ICU experiences, such as isolation, dehumanization, pain, disorientation, traumatic memories, and unclear recall, contribute to PICS. Early and frequent communication is essential.
- Physical weakness involves poor mobility, falls, fatigue, quadriparasis, and impaired speaking/swallowing, often due to prolonged ventilation, sepsis, or deep sedation. Management includes structured physiotherapy and occupational therapy rehabilitation programs.
- Prevention focuses on minimal sedation (using "ABCD bundle" approach), environmental management, frequent patient/family communication, delirium management, and early ambulation. ICU diaries can aid in reorientation and reduce depression/anxiety.
- Post-ICU clinics offer follow-up, counseling, and support, assessing functional status, mental health, muscle strength, and cognitive function. The long-term prognosis varies depending on illness severity, impairment at discharge, and pre-existing functionality.
Sample Certificate
About the Speakers
Dr Sanjeev Pratap
Emergency & Critical Care Physician, NABH Assessor & Professor MIOT International, Tamilnadu
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