Help Is Available for Post-Intensive Care Syndrome

After surviving a critical illness in intensive care, it’s common to have lingering effects such as weakness, fatigue and problems thinking clearly.

Many patients experience ongoing physical, emotional or cognitive problems, a phenomenon called post-intensive care syndrome (PICS). As advanced medical care has enabled more patients to survive severe illness and injury, more attention is being focused on the need for follow-up care to help these patients regain quality of life.

University Hospitals has created a special clinic to help patients recover quicker from the effects of an intensive care stay. The UH Post-ICU Recovery Clinic started in 2020, and is one of 37 such programs worldwide.

“We realized people don’t go back to normal,” says nurse practitioner Kehllee Popovich, CNP, who runs with program with senior clinical nurse specialist Janet Kloos, CNS.

“They can’t resume their lives as they used to live them,” says Popovich. “They experience cognitive and emotional problems, and they experience weakness and frailty because they lose a lot of muscle mass.”

Symptoms Persist After ICU Care

About 75 percent of ICU survivors experience emotional disturbances such as anxiety and post-traumatic stress. Many face challenges returning to daily activities and work. Some problems may resolve in a few weeks, while others can last for months or a year.

Common symptoms after an ICU stay may include:

• Weakness and fatigue
• Confusion
• Shortness of breath
• Difficulty concentrating
• Memory problems
• Anxiety, depression and post-traumatic stress
• Difficulty sleeping

Finding a New Normal After an ICU Stay

The UH Post-ICU Recovery Clinic may refer patients for mental healthcare, physical therapy, occupational therapy, pain management, pulmonology and other specialty services.

Patients often are grateful just to talk about their post-ICU experiences, Popovich says. “I think the biggest impact the clinic makes is validating what is happening. The patients want to know, is this normal? Why am I having nightmares? Why am I having flashbacks? Why can’t I remember phone numbers?”

“A lot of patients have confused memories,” Popovich says. “They are mostly sedated or heavily medicated in the ICU, so the things they’re processing aren’t always reality. A diary helps them match memories to what actually happened.”

Having a family member keep an ICU diary to process memories later is one step you can take to help patients recover quicker and reduce risks of developing PICS. Others include:

• Start movement as soon as possible. Family or caregivers can help patients move their arms and legs and sit up in bed if the patient is too weak to move themselves.
• Interact with family and friends in the hospital. Talking, sharing things such as photos and music, can aid recovery even if the patient isn’t fully conscious.
• Get out of bed, stand, sit in chair or walk with a cane or walker as early as a doctor says it’s safe to do so.
• Start exercise and physical therapy as early as possible.

The goal of the UH Post-ICU Recovery Clinic is to help patients regain function, stability and quality of life. Patients can access clinic services in person at the UH Cleveland Medical Center or by telehealth.