Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 0 0 2026 07 13 1654 1654 Fatemeh Afra Department of Clinical Pharmacy, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Khashayar Shahverdi Department of Anesthesiology and Critical Care, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Leila Sadat Hosseini Department of Anesthesiology and Critical Care, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Hanieh Jalalian Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Parsa Dokhani Department of Pharmaceutical Biomaterials, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Negin Davoudi Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Ziba Aghsaeifard Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Atabak Najafi Department of Anesthesiology and Critical Care, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Amirmahdi Mojtahedzadeh Center For Undergraduate Students' Study in Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary. Mojtaba Mojtahedzadeh Division of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. & Division of Critical Care Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2026 06 05 2026 06 22 Background: Post-intensive care syndrome (PICS) is a frequent complication of critical illness characterized by persistent physical, cognitive, psychological, and cardiopulmonary impairments. This narrative review summarizes the biological mechanisms underlying PICS and current approaches to its prevention and management. Methods: A narrative review of contemporary experimental and clinical literature was performed to synthesize evidence on the pathophysiology, prevention, rehabilitation, and long-term management of PICS. Results: PICS is driven by interconnected mechanisms and pathways. These pathways contribute to intensive care unit (ICU)-acquired weakness, cognitive impairment, psychological disorders, and chronic cardiopulmonary dysfunction. Emerging strategies, including biological phenotyping, multi-omics technologies, and precision rehabilitation, may facilitate individualized recovery. The review also highlights the impact of PICS on family members (PICS-F). Conclusion: PICS is a heterogeneous multisystem condition requiring an integrated approach from ICU care through long-term rehabilitation. A better understanding of its biological mechanisms may support personalized interventions and improve long-term outcomes for ICU survivors and their families. https://aacc.tums.ac.ir/index.php/aacc/article/view/1654