MEDICAL ADVANCEMENTS IN RECENT YEARS have saved the lives of countless people who, in the past, would have otherwise died from critical illnesses or injuries. In fact, the ICU survival rate is now nearly 90%.
Strangely, however, there is a downside to this otherwise good news. Survivors of ICU hospitalization often suffer from a wide range of debilitating, chronic conditions that tend to worsen over time. This is called Post Intensive Care Syndrome (PICS). Dr. Kenneth Krell is a critical care physician who treated Intensive Care Unit patients at EIRMC for over 20 years. He can attest to the severity and prevalence of PICS. “Shockingly, one year after ICU hospitalization, 78% of survivors experienced difficulties in physical and cognitive function, as well as impaired concentration, anxiety, depression and mental processing,” says Dr. Krell, describing some of the most common complaints of ICU survivors. “At one year, half were unable to return to work or usual activities. In fact, patients worsened over time, with one third experiencing generalized cognitive decline.”
Dr. Krell is now with East Falls Internal Medicine and is focused on diagnosing and treating PICS patients and COVID long haulers. Patients with PICS can have one or more of these symptoms: difficulty breathing, muscle weakness, or balance issues; difficulty completing daily tasks; problems with concentration, thinking, and memory; fatigue, depression, anxiety, sleeplessness, or nightmares. Frustratingly, these symptoms usually get worse, not
better, as time goes on.
It is impossible to identify exactly what causes an ICU patient to develop PICS, but doctors suspect it’s a combination of various lifesaving treatments. The conditions under which patients are admitted to the ICU are extreme to begin with, and extreme measures are required to sustain life.
Equipment such as mechanical ventilators are very invasive, and sedatives and pain medications can have mind-altering effects. Mental and emotional stress and pain usually accompany the physical experience of being hospitalized in an ICU. It all adds up. Because symptoms of PICS vary from patient to patient, East Falls Internal Medicine offers extensive testing for accurate diagnosis. “These patients require a comprehensive evaluation to identify their particular deficits and needs, with family involvement during the entire evaluation and treatment period,” explains Dr. Krell. “A
key component is restorative care, emphasizing graded activity and cognitive and mental health services, with progress monitored by the clinic. We can offer these patients hope—hope for improved quality of life.”
If you or a loved one have experienced declining health after being discharged from an ICU, consider an evaluation at East Falls Internal Medicine. Call (208) 535-4000.