The Long, Winding Road to Recovery After An ICU Stay

Being a patient or having a family member in the intensive care unit (ICU) can undoubtedly be a scary and life-changing experience. What most people, including clinicians, don’t realize is that surviving the illness that caused someone to be in the ICU often marks only the beginning of the recovery journey.

Post Intensive Care Syndrome (PICS) is a term used to describe the physical, cognitive, and mental health impairments that can persist even after critical illness and a person is no longer in the hospital. Critical care medicine has advanced, and more people survive a critical disease than ever before — but there is now increasing recognition of the after-effects of critical illness. It is difficult to capture precisely how often ICU survivors develop post-intensive care syndrome. Still, it’s estimated around 50% will have some form of impairment even one year after their ICU stay.

What are the symptoms of PICS?

Physical impairments often include persistent weakness or problems with mobility, like walking. Cognitive impairments include trouble with memory, attention, and thinking clearly. Mental health effects can be more difficult for others to recognize but are often very distressing to the patient. They can include common symptoms of post-traumatic stress disorder (PTSD), including vivid nightmares, severe anxiety, flashbacks, depression, excessive tiredness, irritability, and sleep difficulties.

Who is most at risk of PICS?

• ICU patients who develop shock and require medications to increase their blood pressure
• Those with respiratory failure requiring a ventilator or breathing machine to breathe for them for several days
• Patients who develop delirium (a type of alteration in a patient’s mental status)
• Patients above age 65 or who have certain other pre-existing conditions.

What can you do to help a loved one with PICS?

While it’s difficult to see a loved one so sick, especially when they are unable to communicate with you, having family at the bedside is extremely helpful. In-person family support has been more difficult with the COVID pandemic, be sure to ask about the hospital’s visitation policy.

Some evidence suggests diaries kept during an ICU stay can help fill in the memory gaps of what happened for patients later on. Physical therapy, both in the hospital and after, is essential.

Patients, families, and caregivers need to be aware of PICS for multiple reasons. For ICU survivors affected by PICS, it’s important to know you are not alone and that there are support groups. Families and caregivers should be aware of what to expect as well as available resources, including counseling, support groups, and referral options.