scholarly journals Patient- and family-centered performance measures focused on actionable processes of care for persistent and chronic critical illness: protocol for a systematic review

2017 ◽  
Vol 6 (1) ◽  
Author(s):  
Louise Rose ◽  
◽  
Laura Istanboulian ◽  
Laura Allum ◽  
Lisa Burry ◽  
...  
Keyword(s):  
Systematic Review ◽  
Critical Illness ◽  
Performance Measures ◽  
Processes Of Care ◽  
Chronic Critical Illness ◽  
Family Centered

scholarly journals Patient and Family Centered Actionable Processes of Care and Performance Measures for Persistent and Chronic Critical Illness

2019 ◽  
Vol 1 (4) ◽  
pp. e0005 ◽  
Author(s):  
Louise Rose ◽  
Laura Istanboulian ◽  
Laura Allum ◽  
Lisa Burry ◽  
Craig Dale ◽  
...  
Keyword(s):  
Critical Illness ◽  
Performance Measures ◽  
Processes Of Care ◽  
Chronic Critical Illness ◽  
And Performance ◽  
Family Centered

scholarly journals Slow and Steady: A Systematic Review of ICU Care Models Relevant to Pediatric Chronic Critical Illness

2020 ◽  
Vol 09 (04) ◽  
pp. 233-240
Author(s):  
Rachel Troch ◽  
Jamie Schwartz ◽  
Renee Boss
Keyword(s):  
Systematic Review ◽  
Critical Illness ◽  
Quality Data ◽  
Care Utilization ◽  
Interdisciplinary Management ◽  
Care Needs ◽  
Respiratory Management ◽  
Chronic Critical Illness ◽  
Care Models ◽  
Icu Management

AbstractThere is a growing population of children with prolonged intensive care unit (ICU) hospitalization. These children with chronic critical illness (CCI) have a high health care utilization. Emerging data suggest a mismatch between the ICU acute care models and the daily care needs of these patients. Clinicians and parents report that the frequent treatment alterations typical for ICU care may be interrupting and jeopardizing the slow recoveries typical for children with CCI. These frequent treatment titrations could therefore be prolonging ICU stays even further. The aim of this study is to evaluate and summarize existing literature regarding pace and consistency of ICU care for patients with CCI. We performed a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (of September 2018). PubMed (biomedical and life sciences literature), Excerpta Medica database (EMBASE), and The Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched for English-language studies with data about CCI, care models, and pacing of clinical management. Four unique papers were identified. Our most important finding was that quality data on chronic ICU management, particularly for children, is sparse. All papers in this review confirmed the unique needs of chronic patients, particularly related to respiratory management, which is a common driver of ICU length of stay. Taken together, the papers support the hypothesis that protocols to reduce interdisciplinary management variability and to allow for slower management pacing should be studied for their impact on patient and health system outcomes. Optimizing value in ICU care requires mapping of resources to patient needs, particularly for patients with the most intense resource utilization. For children with CCI, parents and clinicians report that rapid treatment changes undermine recovery and prolong ICU stays. This review highlights the lack of quality pediatric research in this area and supports further investigation of a “slow and steady” approach to ICU management for children with CCI.

scholarly journals Attending to Methodological Challenges in Qualitative Research to Foster Participation of Individuals with Chronic Critical Illness and Communication Impairments

2021 ◽  
Vol 8 ◽  
pp. 233339362110000
Author(s):  
Fuchsia Howard ◽  
Sarah Crowe ◽  
Scott Beck ◽  
Gregory Haljan
Keyword(s):  
Qualitative Research ◽  
Critical Illness ◽  
Therapeutic Relationship ◽  
Prolonged Mechanical Ventilation ◽  
Future Research ◽  
Interpretive Description ◽  
Study Participation ◽  
Chronic Critical Illness ◽  
Conducting Research ◽  
Communication Impairments

Individuals with chronic critical illness experience multiple complex physiological disturbances including ongoing respiratory failure, requiring prolonged mechanical ventilation, and thus communication impairments. In conducting a qualitative interpretive description study, we sought to ensure that individuals with chronic critical illness themselves were included as participants. Our commitment to recruiting these individuals to the study and ensuring their data meaningfully informed the analysis and findings required us to reconsider and challenge some of the traditional notions of high-quality qualitative research and develop appropriate practical strategies. These strategies included: (1) centering participant abilities and preferences, (2) adopting a flexible approach to conducting interviews, (3) engaging in a therapeutic relationship, and (4) valuing “thin” data. In this article, we extend existing literature describing the complexities of conducting research with individuals with communication impairments and strategies to consider in the hopes of informing future research with other populations historically excluded from study participation.

Incidence and risk factors for chronic critical illness: A prospective cohort study

2017 ◽  
Vol 42 ◽  
pp. 405-406
Author(s):  
Paola Tonin Carpeggiani ◽  
Júlia Bertholdo Bossardi ◽  
Fabricio Piccoli Fortuna ◽  
Vanessa Piccoli ◽  
Nicole Elen Lira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Critical Illness ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Chronic Critical Illness

Association of Glycemic Control Parameters with Clinical Outcomes in Chronic Critical Illness

2014 ◽  
Vol 20 (9) ◽  
pp. 884-893 ◽  
Author(s):  
Rifka Schulman ◽  
Erin Moshier ◽  
Lisa Rho ◽  
Martin Casey ◽  
James Godbold ◽  
...  
Keyword(s):  
Critical Illness ◽  
Glycemic Control ◽  
Clinical Outcomes ◽  
Control Parameters ◽  
Chronic Critical Illness

scholarly journals Early interventions for the prevention of post-traumatic stress symptoms in survivors of critical illness: protocol for a systematic review

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e018270 ◽  
Author(s):  
Lindsey J Glaspey ◽  
Michael B Roberts ◽  
Anthony Mazzarelli ◽  
Stephen Trzeciak ◽  
Brian W Roberts
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Critical Illness ◽  
Outcome Measures ◽  
Traumatic Stress ◽  
Early Interventions ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Registration Number ◽  
Post Traumatic

IntroductionPost-traumatic stress disorder (PTSD) is being increasingly reported among survivors of critical illness and injury. Previous work has demonstrated that PTSD reduces patient quality of life and ability to return to work, as well as increases healthcare costs. As such, identifying interventions aimed at preventing the development of critical illness-related PTSD could have an important public health impact. The objective of this systematic review is to collate the world’s literature on early interventions aimed at preventing PTSD among survivors of critical illness.Methods and analysisWe will perform a qualitative systematic review of human clinical trials of interventions aimed at preventing or reducing critical illness-related PTSD symptoms. We will methodically search CENTRAL, MEDLINE, Embase and CINAHL. We will also search websites containing details on clinical trials registration (National Library of Medicine’s ClinicalTrials.gov and the WHO’s International Clinical Trials Registry Platform), as well as screen reference lists of the articles we select for inclusion to identify additional studies for potential inclusion. Two authors will independently review all search results. After identification and inclusion of articles, we will use a standardised form for data extraction. We will use tables to describe the study type, populations, interventions tested and timing of interventions, outcome measures and effects of interventions on outcome measures compared with control groups. This review will be completed between 1 August 2017 and 31 August 2017.Ethics and disseminationThe proposed systematic review will not collect individual patient level data and does not require ethical approval. Results of this study will contribute to the understanding of critical illness-related PTSD and help prompt future research aimed at further developing interventions to prevent PTSD symptoms in survivors of critical illness.PROSPERO registration numberThis systematic review is registered in the PROSPERO international prospective register of systematic reviews (registration number CRD42017069672).

scholarly journals Persistent inflammation, immunosuppression and catabolism syndrome: mechanisms of sarcopenia and ways of correction

2021 ◽  
Vol 16 (7-8) ◽  
pp. 110-117
Author(s):  
S.M. Chuklin ◽  
S.S. Chuklin ◽  
G.V. Shershen
Keyword(s):  
Intensive Care ◽  
Critical Illness ◽  
Necrotizing Pancreatitis ◽  
Clinical Manifestations ◽  
Severe Trauma ◽  
Significant Loss ◽  
Mild Degree ◽  
Persistent Inflammation ◽  
Chronic Critical Illness ◽  
Severe Pathology

Due to advances in intensive care, many patients with severe pathology are discharged from intensive care units. However, prolonged mild degree inflammation persists in some patients, recovery is protracted, and chronic critical illness develops in them. In addition, persistent inflammation, immunosuppression and catabolism arise. In 2012, this condition was identified as a separate syndrome, which can be observed after severe trauma and burns, sepsis, necrotizing pancreatitis. Significant loss of muscle mass that is difficult to correct is one of the leading clinical manifestations in this case. Using literature from the MEDLINE database, modern ideas about the mechanisms of sarcopenia in the persistent inflammation, immunosuppression and catabolism syndrome and possible ways of optimal anabolic support are described.

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