The course of post intensive care syndrome in patients with severe cerebral insufficiency and predictors of recovery. Clinical observation

Abstract

Post-intensive care syndrome (PICS) is currently a problem affecting the entire intensive care strategy. The study of its mechanisms becomes most relevant in regard to the prevention of its development and influence on the disease course in patients with impaired respiratory function, neuromuscular transmission and cognitive disorders requiring long-term protection of the vital functions. The severity of the systemic inflammatory response as an individual reaction of the body has a significant influence on the PICS development and severity, that predetermines the degree of neurological and psychological deficiency. The presence of background somatic diseases, such as diabetes mellitus (including that in the framework of metabolic syndrome), significantly aggravates the course of PICS and contributes to the deceleration of the recovery process. The earliest possible start of rehabilitation with both passive and active measures on the basis of an intensive care unit, followed by an expanded individual rehabilitation program on the basis of a specialized department, leads to the most favorable prognosis for the restoration of both impaired vital functions and for the emerging disorders in the cognitive, motor, and affective spheres. Such an approach reduces the length of stay in the hospital and improves the patients quality of life after the discharge from the hospital.
 The article describes three clinical cases of PIT syndrome. Based on the analysis of the course and severity of this syndrome, the conclusions are drawn about the relationship between the course of the inflammatory process and its effect on the restoration of the impaired functions.