Post-Intensive Care Syndrome
Heidi James, MD and Vanessa Cardy, MD
ICU admission rates have increased due to COVID-19, which means that more of our patients will suffer from post-intensive care syndrome (PICS).
- PICS is a constellation of symptoms
- Cognitive deficits
- Executive functioning
- Increased risk of dementia
- Physical symptoms
- Symptoms may impact patients for the short term, but many are disabled by them for the long term.
- Prevention is key
- Minimize risk of delirium,
- Avoid the hypos: hypoxia, hypoglycemia, hypotension
- The ABCDEFGH approach is a helpful framework to follow to decrease risk of PICS.
- A - Awakening (use minimal amount of sedation as possible)
- B - Breathing (do spontaneous breathing trials)
- C - Coordination of care and communication
- D - All thing delirium
- E - Early ambulation and physical therapy
- F - Functional reconciliation (what was their level of function at baseline?), family involvement and follow-up plans
- G - Good communication between team members.
- H - hand out materials for patients and their families
- Many are impacted by their symptoms long past their discharge from ICU, primary care providers will be managing these patients and will become experts in their care.
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The New York Times: Here’s What Recovery From Covid-19 Looks Like for Many Survivors