What comes after the intensive care unit?

Post-intensive care syndrome

Abstract

Introduction: post-intensive care syndrome (PICS) refers to physical, cognitive and mental impairments produced during an intensive care unit (ICU) stay. Half or more of patients are estimated to suffer from some component of this syndrome. A high index of suspicion is critical for identifying PICS.

Clinical case: we describe the case of an older adult with previous partial independence who, during her ICU stay, developed two PICS components: physical and mental. The weakness acquired in the ICU was diagnosed using the MRC scale, with an initial score of 34. For the mental component, she had high scores on the Hospital Anxiety and Depression Scale. Multidisciplinary management was started with physical medicine and nutritional and psychological support, achieving partial recovery at discharge.

Discussion: this case reflects the importance of a comprehensive and early approach to PICS. While clinical improvement was achieved, late detection limited the use of preventive strategies, like the ABCDEF bundle. The literature supports the use of interventions like early mobility and physical rehabilitation to improve outcomes, although gaps remain in the strategy for the mental component.

Conclusion: this case highlights the need to strengthen the early detection of PICS and institutionalize structured multidisciplinary management beginning in the acute phase. Future studies should focus on cost-effective interventions and longitudinal follow-up of these patients