scholarly journals Post-intensive care syndrome following cardiothoracic critical care: Feasibility of a complex intervention

2021 ◽  
pp. 0
Author(s):  
P Henderson ◽  
T Quasim ◽  
A Asher ◽  
L Campbell ◽  
M Daniel ◽  
...  
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Complex Intervention ◽  
Post Intensive Care Syndrome

Testimonies in Understanding the Psychological and Cognitive Problems Faced by Survivors of Critical Illness

2017 ◽  
Author(s):  
Christina Jones ◽  
Peter Gibb ◽  
Ramona O. Hopkins
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Cognitive Impairment ◽  
Critical Illness ◽  
Physical Therapy ◽  
Cognitive Impairments ◽  
Impaired Memory ◽  
Cognitive Problems ◽  
Substantial Morbidity ◽  
Post Intensive Care Syndrome

Millions of patients are treated in intensive care units (ICUs) each year, and the number of survivors is growing as a result of advances in critical care medicine. Unfortunately, many survivors of critical illness have substantial morbidity. Physical, psychological, and cognitive impairments are particularly common—so much so that a group of clinicians coined the term “post-intensive care syndrome” (PICS) to help raise awareness. Patients surviving critical illnesses are often quite weak, and physical therapy, hopefully starting in the ICU, is vital. But weakness is only one of the problems critical-illness survivors and their loved ones face. Unfortunately, many survivors are left with cognitive impairment (e.g., impaired memory, attention, and executive functioning), as well as distress-related psychiatric phenomena such as posttraumatic stress and depression. Importantly, these problems are not limited to adult patients, and loved ones also suffer. In this chapter the authors describe their personal journeys in coming to understand the suffering and issues that critical-illness survivors and their families face.

A-38 Post-Intensive Care Syndrome in a Cohort of School-Aged Children & Adolescents Receiving Integrated Care Via a Pediatric Critical Care & Neurotrauma Recovery Program

2021 ◽  
Vol 36 (6) ◽  
pp. 1079-1079
Author(s):  
Rachel Greene ◽  
Cydni N Williams ◽  
Trevor A Hall
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Children And Adolescents ◽  
Psychosocial Functioning ◽  
Pearson Correlation ◽  
Neurocognitive Functioning ◽  
School Aged Children ◽  
Direct Assessment ◽  
The Impact ◽  
Post Intensive Care Syndrome

Abstract Objective We aimed to identify critical issues related to Post-Intensive Care Syndrome (PICS) through an integrated model of care whereby children and families participate in follow-up clinics with a neuropsychologist and a critical care physician. To demonstrate the impact of direct assessment, we present pilot program findings on early identification and treatment of PICS in a cohort of school-aged children and adolescents through a combination of multi-professional direct assessment and parent proxy questionnaires. Method 64 children and adolescents ages 8–17 years participated in the current study. PICS issues related to physical, cognitive, and psychosocial health were screened 1–3 months after discharge from the pediatric intensive care unit (PICU). The primary outcome was nine performance-based neurocognitive measures combined through principal components analysis to create a neurocognitive index (NCI). Pearson correlation (r) was used to determine the NCI association with other PICS measures at the p < 0.05 significance level. Results The NCI accounted for 52% of the overall variance. Better NCI performance was significantly associated with improved quality of life (r = 0.4). Poorer neurocognitive functioning was significantly associated with the presence of intracranial lesions on imaging (r = −0.28), a neurodevelopmental (r = −0.3) or neurocognitive (r = −0.29) disorder clinician diagnosis, and parent-reported sleep disturbances (r = −0.5), fatigue (r = −0.46), and global executive functioning (r = −0.42). Conclusions Performance-based measures of neurocognitive functioning were associated with core PICS features including physical, cognitive, and psychosocial functioning. Direct assessment of neurocognitive and psychosocial functioning in the initial healing phase following PICU admission is needed to provide patients and their families with expedited and comprehensive guidance for recovery.

scholarly journals Grip Strength Correlates with Mental Health and Quality of Life after Critical Care: A Retrospective Study in a Post-Intensive Care Syndrome Clinic

2021 ◽  
Vol 10 (14) ◽  
pp. 3044
Author(s):  
Kensuke Nakamura ◽  
Ayako Kawasaki ◽  
Noriyo Suzuki ◽  
Sayaka Hosoi ◽  
Takahiro Fujita ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Illness ◽  
Critical Care ◽  
Intensive Care ◽  
Grip Strength ◽  
Mental Status ◽  
Depression Scale ◽  
Disability Group ◽  
Post Intensive Care Syndrome

Post-intensive care syndrome (PICS) is characterized by several prolonged symptoms after critical care, including physical and cognitive dysfunctions as well as mental illness. In clinical practice, the long-term follow-up of PICS is initiated after patients have been discharged from the intensive care unit, and one of the approaches used is a PICS clinic. Although physical dysfunction and mental illness often present in combination, they have not yet been examined in detail in PICS patients. Grip strength is a useful physical examination for PICS, and is reported to be associated with mental status in the elderly. We herein investigated the relationship between grip strength and the mental status using data from our PICS clinic. We primarily aimed to analyze the correlation between grip strength and the Hospital Anxiety and Depression Scale (HADS) score. We also analyzed the association between grip strength and the EuroQol 5 Dimension (EQ5D) score as quality of life (QOL). Subjects comprised 133 patients who visited the PICS clinic at one month after hospital discharge between August 2019 and December 2020. Total HADS scores were 7 (4, 13) and 10 (6, 16) (p = 0.029) and EQ5D scores were 0.96 (0.84, 1) and 0.77 (0.62, 0.89) (p ≤ 0.0001) in the no walking disability group and walking disability group, respectively. Grip strength negatively correlated with HADS and EQ5D scores. Correlation coefficients were r = −0.25 (p = 0.011) and r = −0.47 (p < 0.0001) for HADS and EQ5D scores, respectively. Grip strength was a useful evaluation that also reflected the mental status and QOL.

scholarly journals Report on the Third International Intensive Care Unit Diary Conference

2020 ◽  
Vol 40 (5) ◽  
pp. e18-e25 ◽  
Author(s):  
Peter Nydahl ◽  
Ingrid Egerod ◽  
Megan M. Hosey ◽  
Dale M. Needham ◽  
Christina Jones ◽  
...  
Keyword(s):  
United States ◽  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Psychiatric Morbidity ◽  
Implementation Strategies ◽  
The United States ◽  
Staff Members ◽  
The Third ◽  
Post Intensive Care Syndrome

Topic Many patients in intensive care units have frightening experiences and memories and subsequent post–intensive care syndrome, with psychiatric morbidity including depression, anxiety, and posttraumatic stress disorder. Intensive care unit diaries, written by staff members and families, support patients’ understanding of what occurred and may alleviate their psychological suffering. Clinical Relevance An increasing number of critical care nurses in the United States and elsewhere are implementing intensive care unit diaries, but implementation remains challenging. Purpose To address emerging questions and support implementation in the United States, we held the Third International Intensive Care Unit Diary Conference as a 1-day preconference during the Seventh Annual Johns Hopkins Critical Care Rehabilitation Conference on November 1, 2018, in Baltimore, Maryland. This article summarizes the conference. Content Covered Conference presentations included intensive care unit–related experiences of patients and families, psychosocial aspects of post–intensive care syndrome, the evolution of diaries, implementation strategies for intensive care unit diaries, special topics (eg, legal issues, electronic vs handwritten diaries, pediatric diaries, and time of handover), and psychosocial recovery.

scholarly journals Post-intensive care syndrome: An overview

2017 ◽  
Vol 5 (2) ◽  
pp. 90-92 ◽  
Author(s):  
Gautam Rawal ◽  
Sankalp Yadav ◽  
Raj Kumar
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Physical Disability ◽  
Early Mobilization ◽  
Signs And Symptoms ◽  
Care Physician ◽  
High Rate ◽  
Critical Care Physician ◽  
Post Intensive Care Syndrome

Abstract Survival of critically unwell patients has improved in the last decade due to advances in critical care medicine. Some of these survivors develop cognitive, psychiatric and /or physical disability after treatment in intensive care unit (ICU), which is now recognized as post intensive care syndrome (PICS). Given the limited awareness about PICS in the medical faculty this aspect is often overlooked which may lead to reduced quality of life and cause a lot of suffering of these patients and their families. Efforts should be directed towards preventing PICS by minimizing sedation and early mobilization during ICU.All critical care survivors should be evaluated for PICS and those having signs and symptoms of it should be managed by a multidisciplinary team which includes critical care physician, neuro-psychiatrist, physiotherapist and respiratory therapist, with the use of pharmacological and non-apharmacological interventions. This can be achieved through an organizational change and improvement, knowing the high rate of incidence of PICS and its adverse effects on the survivor’s life and daily activities and its effect on the survivor’s family.

Framework for Biosignal Interpretation in Intensive Care and Anesthesia

1997 ◽  
Vol 36 (04/05) ◽  
pp. 340-344 ◽  
Author(s):  
I. Korhonen ◽  
M. van Gils ◽  
A. Kari ◽  
N. Saranummi
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Data Management ◽  
Clinical Evaluation ◽  
Patient Monitoring ◽  
Research Community ◽  
Clinical Routine ◽  
The Poor ◽  
Outcomes Of Care

Abstract:Improved monitoring improves outcomes of care. As critical care is “critical”, everything that can be done to detect and prevent complications as early as possible benefits the patients. In spite of major efforts by the research community to develop and apply sophisticated biosignal interpretation methods (BSI), the uptake of the results by industry has been poor. Consequently, the BSI methods used in clinical routine are fairly simple. This paper postulates that the main reason for the poor uptake is the insufficient bridging between the actors (i.e., clinicians, industry and research). This makes it difficult for the BSI developers to understand what can be implemented into commercial systems and what will be accepted by clinicians as routine tools. A framework is suggested that enables improved interaction and cooperation between the actors. This framework is based on the emerging commercial patient monitoring and data management platforms which can be shared and utilized by all concerned, from research to development and finally to clinical evaluation.

The Association of Pediatric Critical Care Medicine Training Programs with Research Publication Productivity and Employment Outcomes of Their Graduates

2020 ◽  
Author(s):  
Sonali Basu ◽  
Robin Horak ◽  
Murray M. Pollack
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Medical School ◽  
Training Programs ◽  
Fellowship Training ◽  
Publication Productivity ◽  
Research Publication ◽  
Pediatric Critical Care ◽  
Publication Success ◽  
Fellowship Programs

AbstractOur objective was to associate characteristics of pediatric critical care medicine (PCCM) fellowship training programs with career outcomes of PCCM physicians, including research publication productivity and employment characteristics. This is a descriptive study using publicly available data from 2557 PCCM physicians from the National Provider Index registry. We analyzed data on a systematic sample of 690 PCCM physicians representing 62 fellowship programs. There was substantial diversity in the characteristics of fellowship training programs in terms of fellowship size, intensive care unit (ICU) bed numbers, age of program, location, research rank of affiliated medical school, and academic metrics based on publication productivity of their graduates standardized over time. The clinical and academic attributes of fellowship training programs were associated with publication success and characteristics of their graduates' employment hospital. Programs with greater publication rate per graduate had more ICU beds and were associated with higher ranked medical schools. At the physician level, training program attributes including larger size, older program, and higher academic metrics were associated with graduates with greater publication productivity. There were varied characteristics of current employment hospitals, with graduates from larger, more academic fellowship training programs more likely to work in larger pediatric intensive care units (24 [interquartile range, IQR: 16–35] vs. 19 [IQR: 12–24] beds; p < 0.001), freestanding children's hospitals (52.6 vs. 26.3%; p < 0.001), hospitals with fellowship programs (57.3 vs. 40.3%; p = 0.01), and higher affiliated medical school research ranks (35.5 [IQR: 14–72] vs. 62 [IQR: 32, unranked]; p < 0.001). Large programs with higher academic metrics train physicians with greater publication success (H index 3 [IQR: 1–7] vs. 2 [IQR: 0–6]; p < 0.001) and greater likelihood of working in large academic centers. These associations may guide prospective trainees as they choose training programs that may foster their career values.

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