What is PICS?
To illustrate what you might experience as a patient, relative or friend, we give you the example of a fellow physiotherapist from the Brabant region. She has shared her experiences through our professional association, the KNGF (Koninklijk Genootschap voor Fysiotherapie, Royal Society of Physiotherapists). In the province of Noord-Brabant, and particularly in the hospital where she works, a great deal of experience with corona/COVID-19 has unfortunately been accumulated.
The inpatients currently on the corona wards are very vulnerable. In fact, those of my patients whose symptoms would normally make them my worst patients are now my best patients. People are gasping for breath, don’t even have the energy to eat and their condition is very poor. And this doesn’t even include the patients in the ICU, who are on ventilators for three to four weeks. Post Intensive Care Syndrome will soon hit us hard. These patients are really very, very vulnerable.
The inpatients currently on the corona wards are very vulnerable. In fact, those of my patients whose symptoms would normally make them my worst patients are now my best patients.
To my colleagues responsible for rehabilitation at home, I would say: prepare yourselves and read what to expect. And when the time comes to treat patients, spread the treatment over a longer period. Given the reduction in patients’ muscle strength and respiratory capacity, they will still need you in several months. It is also uncertain whether so much fibrosis and scar tissue will develop in the lungs that patients will develop chronic breathing problems.
What do we know about the symptoms of PICS?1
Many ICU survivors experience physical, psychological and cognitive problems after leaving the ICU. We call these complex residual symptoms PICS: Post Intensive Care Syndrome. These residual symptoms have a long-term effect on daily life, on patients’ ability to function. The most obvious symptoms are major weight loss and serious muscle weakness. As the nervous system also responds poorly, you can expect that the recovery will have to be slow and gradual. Fatigue plays a major role in this. Patients’ capacity for exertion is not great. Lung damage is a typical factor in COVID-19 rehabilitation. This damage leads to breathing problems among patients.
1 (source of this knowledge: Sommers J, Engelbert RHH, Dettling-Ihnenfeldt D, et al. Physiotherapy in the intensive care unit: an evidence-based, expert-driven, practical statement and rehabilitation recommendations). Clin. Rehabil, 29 (11)
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