Post Intensive Care Syndrome
Post-intensive care syndrome, or PICS, is a collection of problems that exist as a result of illness requiring intensive care treatment. Usually, they arise in the ICU but often continue when the patient returns home. These include weakness, difficultly in thinking and mental health problems.
ICU-Acquired Weakness
ICU-acquired weakness is muscle weakness that develops during a critical illness. This is a common problem of being critically ill and occurs in:
• 33% of all patients on ventilators
• 50% of all patients admitted with severe infection, which is known as sepsis
• Up to 50% of patients who stay in the ICU for at least one week
It can take up to 1 year to recover which makes many of the activities we do not normally have to think about more difficult. This includes dressing, cooking, cleaning, work and exercise.
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Cognitive or Brain Dysfunction
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This refers to problems connected with remembering, paying attention, solving problems, and organizing and working on complex tasks. After leaving the ICU, 30% to 80% of patients may have these kinds of problems. Some people improve during the first year after discharge from the hospital; other people may never fully recover.
Cognitive dysfunction may affect whether the patient can return to work, balance a chequebook, or perform other tasks that involve organisation and concentration.
Mental Health Problems
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Critically ill patients may develop problems with falling or staying asleep. They may have nightmares and unwanted memories. Reminders of their illness may produce intense feelings or strong, clear images in their mind. Their reactions to these feelings may be physical or emotional.
Patients may also feel depressed and anxious and may have symptoms of posttraumatic stress disorder (PTSD). These include having nightmares and unwanted memories and wanting to avoid thinking or talking about their stay in the ICU.
How Does PICS Affect Recovery
Many patients return to work within the first year, but some may not be able to return to the jobs they had prior to their illness.
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What Can Family Do to Minimize PICS fo the patient?
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If you are a family member, you may be able to minimize PICS by helping your critically ill family member stay “oriented”:
• Talk about familiar things, people and events.
• Talk about the day, date and time.
• Bring in favourite pictures and items from home.
• Read aloud at the bedside.
You can also keep a diary or journal and later review it with the care team and your family member. This may help your family member understand what happened, clear up some memories, and reduce stress.
How Does PICS Affect Family?
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Critical illness is a family crisis. Feeling worried and confused can cause family members to stop tending to their own health. The care team may ask the family to make decisions about important, sometimes overwhelming matters. Because of this, 30% of family members may experience their own mental health problems, such as depression, anxiety and PTSD.
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How Can Family Help Lower Their Chances of Developing PICS?
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Critical illness is a family crisis. Feeling worried and confused can cause family members to stop tending to their own health. The care team may ask the family to make decisions about important, sometimes overwhelming matters. Because of this, 30% of family members may experience their own mental health problems, such as depression, anxiety and PTSD.
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After Leaving the ICU
If you were an ICU patient, you may recognise some of these symptoms yourself. Many healthcare professionals do not recognise the symptoms of PICS and appropriate help is often missed.
If you were a patient in the Intensive Care Unit in Jersey you can expect an appointment with the ICU Follow up clinic. If you have been an ICU patient and are a Jersey resident and you feel you would like to help you should contact the Jersey ICU follow up clinic. (01534 442875) Alternatively, the Jersey Critical Care Charity can contact the clinic for you.
You may need help from:
Occupational therapist: A caregiver who helps the patient relearn life skills, such as the activities of daily living and the use of memory.
Physiotherapist: A specialist who helps restore the patient’s ability to function and be independent after injuries to the muscles, bones, tissues and nervous system.
Psychiatrist: A medical doctor who is specially trained to diagnose and treat mental health problems. The psychiatrist can prescribe medication.
Psychologist: An advanced professional who can diagnose and treat problems with thoughts, emotions and coping skills. The psychologist tests and assesses behaviour and mental health.
Speech therapist: A caregiver who helps the patient with problems related to communication and swallowing.
Dietician: A caregiver who provides advice and support on nutrition issues and healthy eating habits.
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