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Review: Post-Intensive Care Syndrome: Unique Challenges in the Neurointensive Care Unit

  • Jamie Nicole LaBuzettaEmail author
  • Jonathan Rosand
  • Ana-Maria Vranceanu
Review

Abstract

Within the last couple of decades, advances in critical care medicine have led to increased survival of critically ill patients, as well as the discovery of notable, long-term health challenges in survivors and their loved ones. The terms post-intensive care syndrome (PICS) and PICS-family (PICS-F) have been used in non-neurocritical care populations to characterize the cognitive, psychiatric, and physical sequelae associated with critical care hospitalization in survivors and their informal caregivers (e.g., family and friends who provide unpaid care). In this review, we first summarize the literature on the cognitive, psychiatric, and physical correlates of PICS and PICS-F in non-neurocritical patient populations and draw attention to their long-term negative health consequences. Next, keeping in mind the distinction between disease-related neurocognitive changes and those that are associated directly with the experience of a critical illness, we review the neuropsychological sequelae among patients with common neurocritical illnesses. We acknowledge the clinical factors contributing to the difficulty in studying PICS in the neurocritical care patient population, provide recommendations for future lines of research, and encourage collaboration among critical care physicians in all specialties to facilitate continuity of care and to help elucidate mechanism(s) of PICS and PICS-F in all critical illness survivors. Finally, we discuss the importance of early detection of PICS and PICS-F as an opportunity for multidisciplinary interventions to prevent and treat new neuropsychological deficits in the neurocritical care population.

Keywords

Post-intensive care syndrome PICS PICS-family Critical care 

Notes

Acknowledgements

The following funding support is acknowledged: Henry and Allison McCance Center for Brain Health (support to Drs. Jonathan Rosand and Ana-Maria Vranceanu), Grant-in-Aid from American Heart Association (support to Dr. Ana-Maria Vranceanu) and 1R21NR017979 (support to Dr. Ana-Maria Vranceanu), National Institutes of Health (JR). Dr. Rosand reports serving as a consultant for Boehringer Ingelheim, Pfizer, and New Beta Innovation.

Author Contributions

JNL conception of review, primary review of literature, drafting of manuscript, final approval for manuscript submission. JR and A-MV reviewed manuscript and provided feedback, final approval for manuscript submission.

Source of Support

This manuscript was supported by a 1R21 NR017979 01A1 (AMV), by a Grant-in-Aid from the American Heart Association (AMV) and by the Henry and Allison McCance Center for Brain Health (AMV, JR).

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society 2019

Authors and Affiliations

  1. 1.Division of Neurocritical Care, Department of NeurosciencesUniversity of California—San DiegoLa JollaUSA
  2. 2.Division of Neurocritical Care and Emergency NeurologyMassachusetts General Hospital and Harvard Medical SchoolBostonUSA
  3. 3.Henry and Allison McCance Center for Brain Health, Massachusetts General HospitalBostonUSA
  4. 4.Integrated Brain Health Clinical and Research Program, Department of PsychiatryMassachusetts General Hospital and Harvard Medical SchoolBostonUSA

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