Understanding PICS: Post-Intensive Care Syndrome
What is PICS?
Post-intensive care syndrome (PICS) is a collection of physical, mental and emotional symptoms that continue to persist after a patient leaves the intensive care unit (ICU).
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Because of the advances in critical care medicine over the last several decades, more people now survive critical illnesses. This has allowed clinicians to shift their focus from immediate short-term outcomes of these patients to the long-term outcomes of survivors of critical illnesses.
What they discovered is that although ICU survival rates have improved, patients may not return to their former level of function for weeks, months and even years. Patients developed physical, mental and emotional symptoms related to their critical illness and treatment in the ICU. This can include ongoing pain, mobility issues, or developing symptoms of anxiety, depression, or post-traumatic stress disorder (PTSD).
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It can be difficult to diagnose PICS as the circumstances leading to a person’s ICU admission and their experience in hospital vary so much case to case. Likewise, every patient will have different coping strategies, support network, and comorbidities that can differ greatly and influence their ICU experience. There is a lack of research exploring in-hospital, modifiable risk factors such as the ICU environment, interactions with staff and other patients, and visits from family and friends. The Critical Care Research Group is looking to close this knowledge gap by examining and reshaping the ICU environment.
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Tracking outcomes post intensive care (TOPIC).
We are actively recruiting to new projects aimed at describing recovery after ICU admission, including patient-reported outcomes, predictors, and correlates for patients who experience PICS. As PICS is an emerging condition, current literature addressing the effectiveness of interventions is limited. The TOPIC study aims to collect data from 300 patients over 12-months using clinical records and self-reported instruments to produce results around physical, cognitive, and psychological functioning, at intervals of 6 weeks and 6 months after ICU discharge. With this data we hope to develop prediction and screening tools to improve post-ICU rehabilitation and prevent PICS.
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Screening of ICU Delirium
The Critical Care Research Group has developed an innovative app designed to enable efficient and sensitive screening for delirium without specialist training. Delirium, a common complication of an intensive care unit (ICU) admission, is inconsistently diagnosed by clinicians. Current screening tools require specialist expertise and/or training. Some are time-consuming to administer, and reliability in routine clinical practice is questionable.
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A novel approach to developing a delirium screening tool in the intensive care unit
Delirium is common in the intensive care unit (ICU), often affecting older patients. A bedside electronic tool has the potential to revolutionise delirium screening. Our group describe a novel approach to the design and development of delirium screening questions for the express purpose of use within an electronic device.
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Reshaping the ICU experience to optimise recoveries
We know that ICUs can save lives. But seldom do we stop and consider a patient’s quality of life when they leave hospital.
The Critical Care Research Group is reshaping the ICU experience to ensure patients THRIVE… not just survive.