Improvements in critical care medicine have led to a growing number of patients who survive critical illnesses, including respiratory failure, sepsis and COVID-19.
However, many survivors of the intensive care unit (ICU) experience difficulty with cognition, mental health, and physical function following discharge from the hospital. This clinical syndrome is known as post-intensive care syndrome (PICS), and many symptoms are long lasting, with a significant impact on quality of life.
Some common symptoms after critical illness include:
- Difficulty Sleeping
- Shortness of Breath
Thinking, Memory and Concentration Symptoms
- Signs of short term memory problems
- Difficulty concentrating
- Decision making
- Difficulty getting things done
Mental Health Symptoms
- Signs of depression
- Signs of post-traumatic stress reactions
A healthcare provider may notice symptoms of PICS by asking a person or their caregiver specific questions about how they are doing. There are also formal tests that may provide more information about the severity of the symptoms, including walking tests, lung function tests and questionnaires about anxiety, depression and ability to do daily tasks and overall quality of life. There are no specific blood or radiology tests to diagnose PICS. Your healthcare provider may advise some tests to check for other health conditions needing to be treated. (American Thoracic Society, 2020)
Treatment for PICS depends on the specific symptoms. Weakness and deconditioning can be treated with physical therapy and exercise programs. Mental health symptoms such as depression or anxiety can be treated with a combination of therapy and medications. If cognitive impairment results in difficulty thinking, remembering, or concentrating, a formal evaluation by a neurocognitive specialist may help. Treatment plans may involve several professionals working as a team, such as the one found in our Post ICU Longitudinal Survivor Experience Clinic. (American Thoracic Society, 2020)
U-M PULSE Post-Intensive Care Clinic
The University of Michigan Post ICU Longitudinal Survivor Experience Clinic (U-M PULSE) is designed to help patients and their families manage this challenging time following discharge from the intensive care unit (ICU). The U-M PULSE team partners with you and your family to provide medical care and expert guidance after critical illness. Download a flyer with information about the U-M Pulse Clinic.
What to Expect
All patients are seen by a clinical pharmacist, a social worker, physician and physical therapist. Additional providers, including a dietician and spiritual care specialist are available for consultation in the clinic.
Each patient will receive a comprehensive medication review by the clinical pharmacist, paying particular attention to medication changes which were made during the hospitalization and medications which are not indicated. A social worker who specializes in post-traumatic stress, anxiety, and major life changes will perform a comprehensive assessment of each patient, including evaluation of cognitive function, support systems, mental health, and employment and financial status.
The U-M PULSE team works to:
- Identify the changes that are most disruptive to your life.
- Identify your strengths and supports.
- Develop a comprehensive care plan that addresses your goals.
- Help you access additional services and support.
Make an Appointment
Because recovery does not end when a patient is discharged from the ICU, the U-M PULSE clinic’s multidisciplinary team is here to help. To schedule an appointment with the PULSE clinic, call us at 734-647-9342 and request an appointment.