Post-Intensive Care Syndrome after Critical Illness: An Imperative for Effective Prevention

Paul, Nicolas; Weiß, Björn

doi:10.3390/jcm11206203

Cited by 4 publications

(10 citation statements)

References 30 publications

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“…For example, their physiological function is reduced by their multiple acute and chronic morbidities and by their medical or surgical, outpatient, or inpatient management [6]. PICS encompasses the cognitive, physical, social, and/or psychiatric dysfunctions that persist after hospital discharge; these dimensions are interrelated, and more than half of the patients admitted to ICU will have repercussions in one of the axes, as mentioned above [9].…”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

“…These include previously diminished cognitive reserve, addictions such as excessive alcohol consumption, comorbidities, and lack of control of chronic diseases [8]. On the other hand, there are the factors of hospitalization in ICU, which involve the duration of delirium in ICU, presence of severe sepsis or systemic inflammatory response syndrome, prolonged use of mechanical ventilation, considered as more than 7 days, prolonged sedation, dysglycemia and the use of psychotropic drugs [7,9,10]. However, we found protective factors such as the educational level, which translates into greater cognitive reserve and is associated with lower rates of dementia and depression [8].…”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

“…Another factor is an early mobilization to avoid post-discharge physical deterioration, affecting approximately one-third of ICU patients. It is associated with prolonged mechanical ventilation, sepsis, systemic inflammatory response syndrome, multiorgan failure, and a more extended hospital stay in ICU [9,10]. The deterioration of mental status after ICU stay is associated with female sex, depression, anxiety or pre-existing post-traumatic stress disorder, and alcoholism [11].…”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

“…care patients has led to the development of post-intensive care syndrome and difficulty returning to the original level of pre-ICU function among the survivors [15]. PICS is multifactorial and multifaceted, consisting of physical impairments, cognitive deficits, and mental health problems in ICU survivors and their families [9,11,[16][17][18][19]. Complications are more common in septic ICU patients and endure for years post-ICU.…”

Section: Journal Of Anesthesia and Intensive Care Medicinementioning

confidence: 99%

“…Complications are more common in septic ICU patients and endure for years post-ICU. The risk factors for PICS depend partly on which cognitive, psychiatric, and physical domains are affected the most [9,18]. Impairment in one area is frequently associated with a decline in the performance of another [9].…”

Section: Journal Of Anesthesia and Intensive Care Medicinementioning

confidence: 99%

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Insights into Post-Intensive Care Syndrome, A Complex and Multifaceted Condition

Bonilla la Rosa,

Faisal,

Flores

et al. 2023

JAICM

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Post-intensive care syndrome (PICS) is a complex and multifaceted condition that affects a significant proportion of patients who have survived critical illness and received intensive care. The prevalence of PICS is substantial and has been reported to range from 30% to 80% of ICU survivors. PICS has been associated with increased mortality, hospital readmissions, and healthcare utilization, emphasizing the need for comprehensive post-ICU follow-up care. There is a multitude of risk factors that predispose an individual to develop PICS. However, the educational level has been proven protective against developing the condition. Clinical presentation of PICS includes physical impairments, cognitive deficits, and psychological conditions, with some symptoms lasting from months to years post-recovery. The diagnosis is primarily clinical and requires an interdisciplinary medical team to tailor the diagnostic approach and a global health assessment. PICS multidisciplinary team involves critical care physicians, rehabilitation specialists, mental health professionals, and social support networks. Since no treatment is entirely adequate, controlling the underlying cause and prevention is the most used strategy. A multidimensional approach of the "ABCDEF" bundle is recommended for preventing PICS alongside other non-pharmacological practices. Early mobilization, delirium prevention, and tailored rehabilitation programs have shown promising outcomes for these patients. The long-term prognosis of PICS varies extensively and depends on numerous individual factors, including overall health, pre-existing conditions, age, and access to follow-up care. It is also possible to have a recurrence of symptoms after initial recovery, particularly during physical or emotional stress periods. The recovery rates for PICS depend on multiple factors, and the recovery process is usually gradual. Long-term consequences of the syndrome extend beyond the physical, cognitive, and psychological domains. Increased public awareness about PICS is essential to diagnose the condition early before it progresses. This article provides a comprehensive overview of PICS encompassing its characteristics, epidemiology, risk factors, clinical presentation, diagnosis, prevention, management, and prognosis. Further research is needed to refine risk stratification, optimize interventions, and develop novel approaches to mitigate the burden of PICS.

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Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

Section: Journal Of Anesthesia and Intensive Care Medicinementioning

confidence: 99%

Section: Journal Of Anesthesia and Intensive Care Medicinementioning

confidence: 99%

See 3 more Smart Citations

Insights into Post-Intensive Care Syndrome, A Complex and Multifaceted Condition

Bonilla la Rosa,

Faisal,

Flores

et al. 2023

JAICM

View full text Add to dashboard Cite

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Das Post-Intensive Care Syndrom: funktionelle Beeinträchtigungen bei Überlebenden kritischer Erkrankung

Paul,

Weiss

2024

Anaesthesiologie

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Navigating the Urgency: A Narrative Review on the Critical Demand for Robust Outcome Measures in Post-Intensive Care Syndrome (PICS)

Goel,

Arunmozhi

2024

Intensive Care Res

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Background Post intensive care syndrome (PICS) is a new emerging condition affecting more than 80% of the population discharged from Intensive care unit (ICU). It affects the individual with a myriad of symptoms degrading the individual’s quality of life (QoL). Most critical method to prevent this is early diagnosis through a reliable measure taking into account the multidimensional nature of PICS. Thus, this study aims to find out is there a need of a comprehensive assessment scale for PICS covering all the domains. Methods Data was searched on databases incorporating PubMed, Cochrane Library, Google Scholar and EBSCO, Psyc INFO, Web of Science, Scopus, Science Direct, Medline, CINAHL. 18,756 articles were retrieved. It was narrowed down to 20 articles which were finally reviewed. The review summarizing all the reasons why a comprehensive outcome measure is needed for PICS including all the aspects of the syndrome. Furthermore, the review delineates the potential advantages that a novel assessment tool could provide, enriching our comprehension and handling of the intricate ramifications of PICS. Results The review highlights several key findings that underscore the necessity of a thorough outcome measure for assessing PICS: (i) the multifaceted nature of symptoms; (ii) challenges related to underdiagnosis and misdiagnosis; (iii) inconsistencies in assessment measures; (iv) insufficient attention to social aspects; (v) confounding factors related to comorbidities; (vi) the diverse array of assessment measures presently employed. All this is currently contributing to a confusing assessment of PICS leading to increased population affected with multitude of symptoms experienced after ICU discharge. Conclusion The existing assessment instruments for PICS exhibit wide variability in complexity, difficult comparison and evidence integration, thereby complicating therapeutic decisions. The lack of a universally accepted measurement standard increases the challenge of diagnosing and preventing PICS. Additionally, some tools may inaccurately represent PICS characteristics, leading to inconsistent reporting. Thus, there is an urgent demand for a comprehensive, multidimensional tool to provide a valid diagnosis.

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Post-Intensive Care Syndrome after Critical Illness: An Imperative for Effective Prevention

Abstract: Over the last decades, the importance of intensive care has considerably increased [...]

Cited by 4 publications

References 30 publications

Insights into Post-Intensive Care Syndrome, A Complex and Multifaceted Condition

Insights into Post-Intensive Care Syndrome, A Complex and Multifaceted Condition

Das Post-Intensive Care Syndrom: funktionelle Beeinträchtigungen bei Überlebenden kritischer Erkrankung

Navigating the Urgency: A Narrative Review on the Critical Demand for Robust Outcome Measures in Post-Intensive Care Syndrome (PICS)

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