Post-Intensive Care Syndrome (PICS)

We know more now about what happens for patients who have been critically ill requiring ICU care. Many patients develop persistent health problems after ICU. Some patients experience symptoms for weeks, months and even years after ICU.

The name given to these persistent symptoms is “Post-Intensive Care Syndrome (PICS)”. About half of the patients surviving critical illness go on to have PICS.

PICS involves a combination of persistent symptoms. They are divided into 3 groups:

1. Physical symptoms

2. Cognitive (brain) symptoms

  • decreased memory
  • thinking problems
  • difficulty talking
  • forgetfulness
  • poor concentration
  • trouble problem solving and organising

3. Emotional symptoms

PICS can affect both the patient and family.


In ICU a patient is affected by many different things. Firstly, they will be affected by their critical illness or injury. They will also be affected by the use of equipment helping support them. For example many patients need a breathing tube and ventilator to support them. Patients will also be affected by the medications used in ICU. For example strong medications are used for pain relief and sedation. A combination of these things contribute to PICS.


There are a number of steps involved in diagnosing PICS. First, doctors will chat with patients to find out how they are managing. Doctors will ask questions about daily activities. They will do a physical examination to test for muscle weakness.

Patients may be asked to do an assessment of their mental function. Doctors will also be interested in a patient's emotional symptoms. They may ask a patient to fill out a questionnaire to help diagnose anxiety, depression or Post-Traumatic Stress Disorder (PTSD).

Prevention and treatment

The healthcare team work hard to help prevent and treat PICS.

While a patient is in ICU the team will:

  • use the lower range of doses of sedation
  • use the lower range of doses of pain medicines
  • monitor and manage delirium
  • encourage patients to move as soon as possible
  • start exercise and rehabilitation as soon as possible
  • offer psychological support and medications for mental health issues
  • avoid low blood sugar levels and low oxygen levels
  • encourage the patient and family members to keep an ICU diary

After return home from ICU, patients will be:

  • supported to continue an exercise and rehabilitation programme
  • provided with ongoing psychological support for emotional symptoms
  • encouraged to get enough sleep and to eat healthy food
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Related topics

This topic was reviewed by an intensive care specialist in July 2022.

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