BEYOND PICS: a conceptual framework for post-ICU recovery stewardship

As survival from critical illness improves, the global burden of post-intensive care syndrome (PICS) and PICS-family continues to grow, reshaping the goals of modern intensive care. Despite growing awareness, prevention, follow-up and rehabilitation remain fragmented, and important gaps persist in the organisation of recovery-oriented care. We propose BEYOND PICS, a conceptual framework for ICU survivorship built around six complementary pillars: Begin before ICU discharge , Early follow-up and equitable access , Your journey , Ongoing multidomain assessment and rehabilitation , Networked care , and Driving improvement . Rather than describing clinical interventions to be implemented in practice, the framework promotes a coordinated recovery pathway integrating prevention, patient partnership, education, rehabilitation, multidisciplinary collaboration and continuous quality improvement across the peri-ICU continuum. BEYOND PICS is not a clinical bundle or guideline, it provides a mental model to guide the organization of care, integrating the key components of ICU survivorship into a coherent continuum of care while highlighting priorities for future research.

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Publication Details

Journal
Critical Care
Published
2026-08-26
DOI
https://doi.org/10.1186/s13054-026-06285-2
Primary Topic
Intensive Care Unit Cognitive Disorders
Type
article
Field-Weighted Citation Impact
0.00
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article

BEYOND PICS: a conceptual framework for post-ICU recovery stewardship

Christian Stoppe, Simone Piva, Susannah Leaver, Jan De Waele et al.
Critical Care
Intensive Care Unit Cognitive Disorders
article

BEYOND PICS: a conceptual framework for post-ICU recovery stewardship

Christian Stoppe, Simone Piva, Susannah Leaver, Jan De Waele, Sabrina Eggmann, Stefan J Schaller, for the ESICM HSRO, FREM NAHP, PICS&Rehab Sections, Martina Hermann, Cheryl E. Hickmann, Bertrand Guidet, Bjoern Weiss, Michael Beil, Margo van Mol, Marlies Ostermann, Teresa Cardoso, David McWilliams, Anne-Françoise Rousseau
article en

Abstract

As survival from critical illness improves, the global burden of post-intensive care syndrome (PICS) and PICS-family continues to grow, reshaping the goals of modern intensive care. Despite growing awareness, prevention, follow-up and rehabilitation remain fragmented, and important gaps persist in the organisation of recovery-oriented care. We propose BEYOND PICS, a conceptual framework for ICU survivorship built around six complementary pillars: Begin before ICU discharge , Early follow-up and equitable access , Your journey , Ongoing multidomain assessment and rehabilitation , Networked care , and Driving improvement . Rather than describing clinical interventions to be implemented in practice, the framework promotes a coordinated recovery pathway integrating prevention, patient partnership, education, rehabilitation, multidisciplinary collaboration and continuous quality improvement across the peri-ICU continuum. BEYOND PICS is not a clinical bundle or guideline, it provides a mental model to guide the organization of care, integrating the key components of ICU survivorship into a coherent continuum of care while highlighting priorities for future research.

Critical Care
University of Liège (BE), Universidade do Porto (PT), Guy's and St Thomas' NHS Foundation Trust (GB), University Hospital of Bern (CH), St George’s University Hospitals NHS Foundation Trust (GB), Ghent University Hospital (BE), Erasmus MC (NL), Ghent University (BE), Humboldt-Universität zu Berlin (DE), Sorbonne Université (FR), Hospital Padre Américo (PT), Assistance Publique – Hôpitaux de Paris (FR), NHS Highland (GB), Hôpital Saint-Antoine (FR), Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT), Haute École Provinciale de Hainaut Condorcet (BE), Universitätsklinikum Würzburg (DE), University Children's Hospital Zurich (CH), Haute École Louvain en Hainaut (BE), Decision Sciences (United States) (US), McGill University (CA), Monash University (AU), Coventry University (GB), Medical University of Vienna (AT), University of Brescia (IT), Erasmus University Rotterdam (NL)
Partnerships for the goals
Openalex Percentile: Top 9%
Intensive Care Unit Cognitive Disorders
DOIOpen Access PDFOpenAlex
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