Patients discharged from intensive care units often face a lengthy struggle with lingering physical, cognitive, and psychological problems. Joseph Masterson, a 63-year-old lawyer who survived cardiac arrest and spent 18 days in the medical intensive care unit at UPMC Mercy hospital, including 14 days on a ventilator, exemplifies these challenges. Discharged in February after developing delirium during his stay, Masterson has regained the ability to walk and manage personal care, but continues to experience significant memory loss, struggling to recall conversations from hours earlier and unable to operate a microwave or place a phone call.
Healthcare professionals call these persistent symptoms “post-intensive care syndrome,” or PICS. According to research, more than half of the more than 5 million people admitted annually to intensive care across about 5,000 American hospitals experience such aftereffects, with older age increasing the odds. In a study of patients 70 and older, within six months after discharge only about half had returned to their pre-ICU functional ability. PICS symptoms range from physical weakness, pain, neuropathy, and malnutrition to anxiety and depression, along with cognitive difficulties including problems with memory, attention and concentration, and language.
Causes and Clinical Response
The aggressive treatments that save ICU patients’ lives contribute to the syndrome. Sedating drugs used during ventilation can precipitate delirium, which is the key factor in cognitive symptoms. Constant monitor alarms and bright lighting disrupt sleep, while restrictive family visiting hours deprive patients of reassuring faces and voices. Immobilization causes rapid loss of muscle mass and strength. PTSD is quite common among post-ICU patients, similar to what is seen in combat veterans or sexual assault survivors.
Recognizing these problems, approximately 35 U.S. hospitals have established post-ICU clinics. Vanderbilt’s clinic saw its first patient in 2012, while Yale opened its clinic in 2022. The Critical Illness Recovery Center at the University of Pittsburgh Medical Center, founded in 2018, works with about 100 patients a year. These clinics employ interventions recommended by the Society of Critical Care Medicine, including lighter sedation, earlier mobilization, daily breathing tests, and fewer restrictions on family visits.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://kffhealthnews.org/news/article/post-icu-patients-pics-physical-cognitive-mental-health-aftereffects/