Semin Neurol 2024; 44(03): 398-411
DOI: 10.1055/s-0044-1787011
Review Article

Post–Intensive Care Syndrome in Neurocritical Care Patients

Neha S. Dangayach
1   Department of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY
Natalie Kreitzer
2   Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
Brandon Foreman
3   Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio
Jenna Tosto-Mancuso
4   Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY
› Author Affiliations


Post–intensive care syndrome (PICS) refers to unintended consequences of critical care that manifest as new or worsening impairments in physical functioning, cognitive ability, or mental health. As intensive care unit (ICU) survival continues to improve, PICS is becoming increasingly recognized as a public health problem. Studies that focus on PICS have typically excluded patients with acute brain injuries and chronic neurodegenerative problems. However, patients who require neurocritical care undoubtedly suffer from impairments that overlap substantially with those encompassed by PICS. A major challenge is to distinguish between impairments related to brain injury and those that occur as a consequence of critical care. The general principles for the prevention and management of PICS and multidomain impairments in patients with moderate and severe neurological injuries are similar including the ICU liberation bundle, multidisciplinary team-based care throughout the continuum of care, and increasing awareness regarding the challenges of critical care survivorship among patients, families, and multidisciplinary team members. An extension of this concept, PICS-Family (PICS-F) refers to the mental health consequences of the intensive care experience for families and loved ones of ICU survivors. A dyadic approach to ICU survivorship with an emphasis on recognizing families and caregivers that may be at risk of developing PICS-F after neurocritical care illness can help improve outcomes for ICU survivors. In this review, we will summarize our current understanding of PICS and PICS-F, emerging literature on PICS in severe acute brain injury, strategies for preventing and treating PICS, and share our recommendations for future directions.

Publication History

Article published online:
19 June 2024

© 2024. Thieme. All rights reserved.

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