Post-Intensive Care Syndrome（PICS）の概念と対策 : 睡眠障害と譫妄を中心に

Over the past few decades, advances of intensive care have resulted in improved short-term mortality of critically ill patients. However, many survivors experience impairment in cognition, mental health, and physical function, known as post-intensive care syndrome（PICS）. The mental health of family members may also be adversely affected, which is termed PICS-Family（PICS-F）. More than half of all ICU survivors suffer from at least one PICS-related impairment, and these effects can persist as long as five or more years. PICS may develop by severe underling disease, invasive treatments, medication and environmental factors in the ICU. Especially, sleep disturbance and delirium in the ICU are major exacerbation factors of PICS. Prevention and early intervention for patients with PICS are critical due to a typically poor natural course of this syndrome after clinically significant PICS.
In this topic, we review the definition, clinical manifestations and treatment of PICS. We focus on the treatment of sleep disturbance and ICU-acquired delirium in critically ill patients as preventive strategies of PICS.