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Background <p>The consequences of a&#xa0;critical illness following treatment in an intensive care unit (ICU) are subsumed as post-intensive care syndrome (PICS). This heterogenous syndrome is characterized by new or intensified impairments of physical, cognitive, and/or psychological functions, which outlast acute hospitalization. Symptoms may occur within 24 h following ICU admission and may persist for 5–15&#xa0;years.</p> Aim <p>The aim of this work was to develop a&#xa0;multidisciplinary and multiprofessional guideline for the rehabilitative therapy of PICS and to facilitate appropriate health system structures.</p> Methods <p>A&#xa0;multidisciplinary working group developed 10&#xa0;questions to be addressed by the guideline. Following the PICO system (population, intervention, comparison, and outcome), a&#xa0;systematic literature search and evaluation was conducted for each question and recommendations were derived on the basis of a&#xa0;qualitative synthesis. These were classified as “strong recommendation”, “recommendations” and “therapeutic options”.</p> Results <p>The present evidence led to 12&#xa0;treatment recommendations and 4&#xa0;therapeutic options for the prevention or treatment of PICS. Recommendations concern early mobilization, motor training, and detection of dysphagia. Interventions for delirium prevention should include multimodal stimulation. ICU diaries should be kept to reduce symptoms of posttraumatic stress disorder, anxiety, and depression. The diagnosis of PICS requires repeated assessments of cognitive, psychological and/or motor functions in the in- and out-patient setting.</p> Conclusion <p>PICS is a&#xa0;variable and complex syndrome that requires an individual multidisciplinary and multiprofessional approach as well as continuity of care. Recognition of PICS demands assessment and therapy of motor, cognitive, and psychological health impairments.</p>

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Das Post-Intensive-Care-Syndrom (PICS)

  • 期刊论文

  • 发表日期：

    2025年3月12日

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  • Carolin Renner,
  • Marie-Madlen Jeitziner,
  • Martina Lück,
  • Ricki Nusser-Müller-Busch,
  • Maria-Dorothea Heidler,
  • Andreas Schäfer,
  • Bettina Scheffler,
  • Gudrun Zimmerman,
  • Sabine Brinkmann,
  • Peter Nydahl,
  • Monika Albert,
  • Karin Diserens,
  • Peter Sandor,
  • Claus-W. Wallesch,
  • Imanuel Dzialowski

摘要

Background

The consequences of a critical illness following treatment in an intensive care unit (ICU) are subsumed as post-intensive care syndrome (PICS). This heterogenous syndrome is characterized by new or intensified impairments of physical, cognitive, and/or psychological functions, which outlast acute hospitalization. Symptoms may occur within 24 h following ICU admission and may persist for 5–15 years.

Aim

The aim of this work was to develop a multidisciplinary and multiprofessional guideline for the rehabilitative therapy of PICS and to facilitate appropriate health system structures.

Methods

A multidisciplinary working group developed 10 questions to be addressed by the guideline. Following the PICO system (population, intervention, comparison, and outcome), a systematic literature search and evaluation was conducted for each question and recommendations were derived on the basis of a qualitative synthesis. These were classified as “strong recommendation”, “recommendations” and “therapeutic options”.

Results

The present evidence led to 12 treatment recommendations and 4 therapeutic options for the prevention or treatment of PICS. Recommendations concern early mobilization, motor training, and detection of dysphagia. Interventions for delirium prevention should include multimodal stimulation. ICU diaries should be kept to reduce symptoms of posttraumatic stress disorder, anxiety, and depression. The diagnosis of PICS requires repeated assessments of cognitive, psychological and/or motor functions in the in- and out-patient setting.

Conclusion

PICS is a variable and complex syndrome that requires an individual multidisciplinary and multiprofessional approach as well as continuity of care. Recognition of PICS demands assessment and therapy of motor, cognitive, and psychological health impairments.