Post-Intensive Care Syndrome (PICS) and Strategies for Functional Recovery and Quality of Life After Hospital Discharge: An Integrative Review

Abstract

Introduction: Post-intensive care syndrome (PICS) represents an important clinical challenge due to the persistence of physical, cognitive, and psychological impairments after hospital discharge among survivors of critical illness. Although advances in intensive care medicine have increased survival rates, many individuals experience prolonged functional limitations, reduced independence, and impaired quality of life. In this context, physical therapy plays a fundamental role in preventing functional decline, restoring respiratory capacity, and improving mobility, acting in an integrated manner with medical teams and other healthcare professionals. Objective: To address post-intensive care syndrome and strategies for functional recovery after hospital discharge, emphasizing the musculoskeletal, respiratory, and functional consequences of critical illness and the role of physical therapy within a multidisciplinary approach aimed at preventing disabilities and improving quality of life. Methods: This study consists of a descriptive and analytical literature review conducted through an integrative review methodology. The databases used were the Virtual Health Library (VHL), Latin American and Caribbean Health Sciences Literature (LILACS), National Library of Medicine (PubMed), SciVerse Scopus (Scopus), and Scientific Electronic Library Online (SciELO). Twelve studies published between 1999 and 2020 were included, selected according to their relevance to post-intensive care syndrome, encompassing aspects related to intensive care unit-acquired weakness, early mobilization, physical therapy rehabilitation, functional recovery, and quality of life after hospital discharge. Results: The analyzed evidence demonstrates that survivors of critical illness frequently present persistent functional limitations, including reduced muscle strength, impaired physical capacity, respiratory dysfunction, and negative impacts on quality of life. Prolonged immobilization, mechanical ventilation, disease severity, and intensive care hospitalization are associated with the development of PICS. Physical therapy interventions, including early mobilization, therapeutic exercises, muscle strengthening, respiratory therapy, and structured rehabilitation programs, demonstrated benefits in functional recovery, prevention of intensive care unit-acquired weakness, and improvement of patient independence. The integration of intensive care medicine, physical therapy, and multidisciplinary care was essential to optimize recovery after hospital discharge. Conclusion: Recovery after intensive care requires a continuous interdisciplinary approach, in which physical therapy plays a central role in preventing and treating limitations associated with post-intensive care syndrome. Early and structured physical therapy strategies significantly contribute to functional recovery, improved quality of life, reduction of disabilities, and better clinical outcomes among survivors of critical illness.