Post-Intensive Care Syndrome (PICS)
Symptoms of PICS:
- Physical Domain: Generalized weakness, Fatigue, Difficulty walking
- Cognitive Domain: Memory disturbance/loss, Slow mental processing, Poor concentration
- Emotional Domain: Anxiety, PTSD, Depression
COMMON RISK FACTORS
- ICU length of stay >24 hours, Prolonged immobilization, Severity of illness
- Prior psychiatric illnesses, Prior cognitive impairment, Lower socioeconomic status
- Older age (>65), Female gender
- Exposure to glucocorticoids, Prolonged use of sedation and/or analgesia drips, Hyperglycemia
PREVENTION AND SCREENING
• Implementation of the ABCDEF bundle
- Spontaneous awakening and breathing trials
- Choice of sedation and analgesics
- Delirium screening and prevention
- Early mobilization
- Family presence at bedside
• Use of validated scales to screen and guide targeted treatments
- Delirium screening (CAM-ICU)
- Pain assessment (CPOT, VAS)
- Sedation titration (RASS)
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