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Post-intensive care syndrome describes a collection of health disorders that are common among patients who survive critical illness and intensive care. Generally, PICS is considered distinct from the impairments experienced by those who survive critical illness and intensive care following traumatic brain injury and stroke. The range of symptoms that PICS describes falls under three broad categories: physical impairment, cognitive impairment, and psychiatric impairment. A person with PICS may have symptoms from one or multiple of these categories.
Improvements in survival after a critical illness have led to research focused on long-term outcomes for these patients. This improved survival has also led to the discovery of significant functional disabilities that many survivors of critical illness experience. Because the majority of literature in critical care medicine is focused on short-term outcomes , the current understanding of PICS is relatively limited. Recent research suggests that there is significant overlap among the three broad categories of symptoms. Also, sedation and prolonged immobilization seem to be common themes among patients who have PICS.
The term PICS arose around 2010, at least in part, to raise awareness of the important long-term dysfunctions resulting from treatment in the intensive care unit. Awareness of these long-term functional disabilities is growing, and research is ongoing to further clarify the spectrum of disabilities and to find more effective ways to prevent these long-term complications and to more effectively treat functional recovery. Increased awareness in the medical community has also highlighted the need for more hospital and community-based resources to more effectively identify and treat patients with PICS after surviving a critical illness.
Grouping these impairments together within a syndrome was done to increase awareness of post-critical illness issues. However, an updated definition was required to accommodate new knowledge on PICS. A current and holistic definition of PICS is the new or worsening impairment to the physical, mental, cognitive, employment, and/or social domains of health following critical illness. These five impairments are the defining characteristics of PICS and will be discussed below.