From Resuscitation to Rehabilitation: The Post-Intensive Care Syndrome Continuum in Sepsis Care

Sepsis and septic shock affect nearly 49 million people worldwide each year. Although advances in early recognition and evidence-based management have improved survival, many patients experience long-term cognitive, physical, and psychological impairments collectively known as post-intensive care syndrome (PICS). These sequelae often extend to families and caregivers (PICS-F), resulting in lasting declines in quality of life. Recovery from sepsis represents a continuum that begins during intensive care and extends into survivorship. Decisions regarding analgesia, sedation, delirium prevention, mobilization, and family engagement shape this recovery trajectory. The ABCDEF bundle provides an evidence-based framework to mitigate these long-term effects through structured approaches to pain control, paired awakening and breathing trials, targeted sedation, early mobility, and family involvement. This narrative review synthesizes current evidence on PICS in sepsis and septic shock and examines how implementation of the ABCDEF bundle across the continuum of care can reduce the incidence and severity of post-ICU impairments. Reframing sepsis survivorship as an ongoing process rather than an endpoint underscores the need for critical care practices that promote not only survival but also restoration of function, cognition, and quality of life.