Post–Intensive Care Syndrome: Nursing Assessment, Long-Term Sequelae, and Interprofessional Rehabilitation Strategies
Abstract
Background: Advances in critical care have improved survival rates, but many ICU survivors experience persistent physical, cognitive, and psychological impairments collectively termed Post–Intensive Care Syndrome (PICS). These sequelae also affect family members (PICS-F) and pediatric populations (PICS-p), creating multidimensional recovery challenges.
Aim: To review the etiology, epidemiology, pathophysiology, assessment, and management strategies for PICS, emphasizing nursing roles and interprofessional collaboration.
Methods: A comprehensive literature synthesis was conducted, integrating evidence from multicenter cohort studies, systematic reviews, and expert consensus guidelines to outline PICS domains, risk factors, and prevention frameworks.
Results: PICS prevalence is high: physical impairment occurs in 25–80% of adult ICU survivors, cognitive deficits in up to 80%, and PTSD in up to 50%. Family members exhibit anxiety and depression in up to 75% of cases. Pediatric survivors face functional limitations affecting school and social integration. Etiology is multifactorial, involving ICU-acquired weakness, systemic inflammation, delirium, metabolic instability, and psychological trauma. The ABCDEF bundle—addressing pain, sedation, delirium, mobility, and family engagement—emerges as the cornerstone of prevention. Post-discharge interventions, including ICU diaries and telemedicine follow-up, offer modest benefits but remain essential for continuity of care.
Conclusion: PICS represents a predictable consequence of critical illness requiring proactive prevention during ICU care and structured post-discharge evaluation. Nursing leadership is pivotal in implementing prevention bundles, educating families, and coordinating multidisciplinary rehabilitation.
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References
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Copyright (c) 2025 Mariam Ali Alsalman, Alshaymaa Alghamdi, Areej Mohammed Essa Khormi, Faisal Fahad Almutairi, Rajha Hussain Master Alshahrani, Ahlam Ayed Awad Allah Almutairi, Mariam Ahmad Aldoukhi, Yasamiyan Hamad Awaji, Mawada Mohammed Alshammari, Randa Najeeb Almasoud, Haifa Hawyan Alyazidi, Yahya Mohammed Alamri
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