What Is Post-ICU Syndrome (PICS)?
Post-Intensive Care Syndrome (PICS)
Surviving a critical illness is remarkable. But for many people, discharge from the ICU is not the end of the story -- it's the beginning of a new and often unexpected chapter. Post-Intensive Care Syndrome, or PICS, is the name given to the constellation of physical, cognitive, and mental health challenges that can persist long after a person leaves the intensive care unit.
If you or someone you love has experienced lingering weakness, memory problems, anxiety, depression, or sleep disturbances after a serious illness or ICU stay, you are not alone -- and what you are experiencing has a name.
What Is PICS?
PICS stands for Post-Intensive Care Syndrome. It describes new or worsening impairments that develop during or after critical illness, affecting three domains:
Physical: muscle weakness, fatigue, difficulty breathing, reduced mobility
Cognitive: memory loss, difficulty concentrating, slowed thinking
Mental health: anxiety, depression, post-traumatic stress disorder (PTSD)
Families and caregivers are not immune to being impacted either. PICS-F (PICS-Family) refers to the psychological impact that loved ones experience as a result of a family member's critical illness, including their own anxiety, depression, and grief.
Who Is at Risk?
Anyone who has spent time in an ICU can develop PICS, but certain experiences increase the risk. Survivors of sepsis and ARDS (Acute Respiratory Distress Syndrome) are especially vulnerable, due to prolonged ICU admissions, the severity of their illness, and the frequent need for mechanical ventilation.
Sepsis Alliance -- education, advocacy, and support for sepsis survivors and families
ARDS Alliance -- resources and community for those affected by ARDS
Why PICS Often Goes Unrecognized
Many survivors leave the hospital without ever being told that PICS exists. They may assume their struggles are a personal failing, a sign of weakness, or simply "how things are now." Clinicians, too, have historically focused on survival as the endpoint with less attention given to what life looks like afterward.
Identifying PICS early matters. Research has explored how to screen for PICS from the patient's perspective and what a more proactive approach to recognition might look like.
Post ICU Resources for Patients and Families
Below you will find a variety of resources on PICS and life after the ICU. If you have a resource that has been helpful for you, please share it here.
Books
Every Deep-Drawn Breath by Dr. Wes Ely
If there is one book the critical care survivorship community returns to again and again, it is this one. Dr. Ely is a pioneer in ICU survivorship research and a deeply compassionate physician. His book is part memoir, part science, and entirely human, a must-read for survivors, families, and clinicians alike.
Every Deep-Drawn Breath on Amazon
Vanessa Abraham - Author, SLP and advocate for others with PICS
Vanessa wrote a book sharing the story of her ICU journey and what it was like to start healing after the ICU. She is also a fierce advocate for others who are experiencing PICS and she regularly writes about PICS and healing from ICU experiences on Substack.
Podcasts
ICU Focused Episodes from The Medical Trauma Support Podcast
Post ICU Syndrome with Kali Dayton
Finding Purpose After the ICU with Danielle Burton
What No One Tells You About Life After the ICU with Vanessa Abraham
Parenting Through Medical Trauma with Vanessa Abraham
From ICU to Lifelong Bond: A doctor and patient’s story of healing humanity and hope
Deborah’s ICU Experience and Near Death Experience
Kali Dayton’s ICU Podcasts
Hosted by Kali Dayton, DNP, this podcast is an extraordinary resource for anyone touched by critical illness. Kali brings together survivors, families, and clinicians to talk honestly about what life in and after the ICU really looks like. Her episodes are grounded, research-informed, and deeply validating.
Also from Kali Dayton, DNP, this companion podcast is geared toward helping families and caregivers understand what is happening in the ICU and how to navigate it.
Other ICU Podcasts
Podcast: The Hidden Struggles of ICU Survivors (via Find Empathy) featuring ICU survivor Kirsten Harrell: https://find-empathy.castos.com/episodes/beyond-the-icu-mental-health-perspectives-on-post-intensive-care-syndrome
New podcast series - Intensive Caring: Voices from the ICU (with Dr. David Hornstein) -https://podcasts.apple.com/ca/podcast/intensive-caring-voices-from-the-icu/id1880384322
Videos
Going Back to “Normal” After ICU Discharge JAMA Film Documents Post–Intensive Care Syndrome (PICS)
Lee Powers’ Oxford Talk - “Surviving Post-Intensive Care Syndrome:” https://www.youtube.com/watch?v=o8TTKmcjGwM
Understanding PICS Part 1: The Survivor Perspective - https://www.youtube.com/watch?v=L6q_w05JPRk&t=1202s
Understanding PICS Part 2: The Clinician Perspective - https://www.youtube.com/watch?v=X0tO_aEIqBA
Articles and Blog Posts
Screening for post-intensive care syndrome: Patient perspectives and a call to action(PubMed)
ICU Memories in Survivors of Acute Respiratory Distress Syndrome During COVID-19: A Qualitative Study(PubMed)
Support Groups
Medical Trauma Support Circle
This a peer support community for people who have experienced medical trauma, including PICS. We have weekly peer support groups, education on medical trauma and the nervous system and resources to help navigate life after medical trauma. It is a group of compassionate people who show up for each other and support each other both in peer groups and within the community.
Vanderbilt Health ICU Survivors Weekly Peer Support Group
This group meets Tuesdays at 1pm Central over Zoom. Contact Jenna MacDonald for more information (Jennifer.macdonald@vumc.org)
Vanderbilt Health PICS 101
12-week class combines education about Post-Intensive Care Syndrome with peer support. Cohorts are offered in the spring and in the fall. To express interest, fill out this form: https://redcap.vumc.org/surveys/?s=NRN3HWCJHERM8REC
Critical Care Support Network (CC-SN)
UK-based, survivor-led charity offering a weekly peer support group, family support group, and other activities. https://www.cc-sn.org/
Advocacy Opportunities
Walk-4-PICS
Walk-4-PICSis a community-driven initiative raising awareness of post-intensive care syndrome while encouraging physical recovery. It's a wonderful entry point for survivors who want connection and purpose as part of their healing.
Other Resources
PICS Pocket Card
PICS pocket card - this is a free resource developed by Vanderbilt CIBS Center for ICU survivors living with PICS, designed as a communication aid when working with new providers or having procedures
A Note for Clinicians
PICS is not a niche concern, it affects a significant proportion of ICU survivors and has substantial implications for healthcare utilization, quality of life, and long-term outcomes. Trauma-informed approaches to ICU care, early mobility, minimizing sedation, and post-ICU follow-up programs all play a role in prevention and recovery. The research linked above offers patient-centered perspectives that can meaningfully inform clinical practice.