PICU Basics and Preventing Post Intensive Care Syndrome - Nemours Blog


PICU Basics and Preventing Post Intensive Care Syndrome

PICU Basics and Preventing Post Intensive Care Syndrome

If your child is seriously ill and needs a very high level of medical care, they may be sent to the pediatric intensive care unit (PICU). The PICU is different from other parts of the hospital; it is designed for intensive nursing care and helps for constant monitoring of things like your child’s heart rate, breathing, and blood pressure.

PICU Basics

Your child may be put into the PICU for the following reasons: 

  • Severe breathing problems from asthma
  • Serious infections
  • Certain types of heart conditions
  • Complications of diabetes
  • Post care for major surgery
  • Experienced a serious accident

While in the PICU, you and your child will meet many different members of their medical team. This care team includes:

  • Doctors (often called Attending Physicians), Residents, Fellows and Medical students
  • Nurses
  • Respiratory, Occupational, Physical,  and Speech Therapists
  • Pharmacists
  • Nutritionists
  • Social Workers, Child Life Specialists, Psychologists and Psychiatrists

Children in the PICU will also be surrounded by machines like ventilators and monitors for their heart and blood pressure. Your child will have an IV, where they’ll receive special medicine to stabilize their condition.

Post Intensive Care Syndrome (PICS)

After a critical illness, your child could be at risk of developing Post Intensive Care Syndrome (PICS). This illness is more common in adults who have stayed in intensive care units, but it can also happen to children who have had a PICU stay.

If your child has had a PICU stay and is experiencing the following symptoms, they may have PICS.

  • Fatigue and weakness
  • Trouble with daily activities or other motor dysfunction
  • Learning and attention problems
  • Behavior changes
  • Sadness and depression
  • Nightmares and unwanted memories
  • Difficulty in school, connecting with friends, sleeping, feeding, and communicating

PICS can also affect family members, who may experience anxiety, depression, post-traumatic stress disorder and complicated grief. 

Minimizing the Impacts of PICS

Parents and family members can work with your care team to reduce and prevent PICS for the whole family. While in the PICU and critically ill, the team will help your child optimize their sleep, mobility, and communication.  Family members can talk to the care team about bringing in a child’s familiar items from home such as stuffed animals, favorite books and music.

Additionally, parents and family members need to care for themselves. Be sure your family is eating, getting as much rest and sleep as possible, and seeking support when needed. Social workers and pastoral caregivers can be made available to talk and provide support.

As your child transitions out of the PICU, your care team will also help you prepare for their new healthcare needs, including medications, equipment, therapies, and follow-up appointments with specialists or your child’s primary care doctor.

A stay in the PICU can be confusing and stressful. Ask your child’s care specialists if you’re confused about any medications or therapies they may be receiving. Please let them know if your child or any family members are experiencing symptoms of PICS.

Mindy Fink, MD

Mindy Dickerman Fink, MD, is a physician in the Division of Pediatric Critical Care at Nemours Children's Hospital, Wilmington, Del.