Post-intensive care syndrome (PICS) in children

2021 ◽  
pp. 95-105
Author(s):  
L. K. Karimova ◽  
V. O. Belash

The survival rate of children who require intensive care for life-threatening diseases or injuries has recently increased significantly. In pediatric intensive care, a decrease in mortality is accompanied by an increase in morbidity. This trend has led to a shift in focus of attention from reducing mortality to optimizing outcomes in critically ill patients. A broader approach and focus on outcome in critically ill survivors has been greatly facilitated by the development of a concept that integrates post-intensive care (PIC) diseases into Post Intensive Care Syndrome (PICS). The concept of PIC syndrome implies the occurrence of disorders in patients after IC in three main areas: mental health, cognitive functions and physical health, and also takes into account the state of the family of surviving patients, in particular, parents, who often have a deterioration in mental health. Diagnosis and treatment of this condition involves the work of a multidisciplinary team, in which it is desirable to include an osteopathic doctor in order to more effectively and timely diagnose and correct reversible functional disorders.

2021 ◽  
pp. 103985622110108
Author(s):  
Michelle Anne Adams ◽  
Matthew Brazel ◽  
Richard Thomson ◽  
Hannah Lake

Objectives: To ascertain whether doctors were experiencing higher rates of distress during Covid-19 and whether this was impacted by demographic factors. Our hypotheses were that being a junior doctor, having a previous mental health diagnosis and treating Covid-19 positive patients would predict higher rates of distress. Methods: Cross-sectional survey conducted via Survey Monkey. Voluntary participants were recruited from the mailing list of a national-based referral service for doctors to psychiatrists. Distress was measured using the Kessler Psychological Distress Scale (K10). Demographic factors were analysed for predictive value of a higher rating on the K10. Areas of concern in relation to Covid-19 and preference for support services were measured on a Likert scale and compared to levels of distress. Results: The rate of very high distress was 15%. Being a junior doctor and having a previous mental health diagnosis were predictive factors of a higher K10 score. K10 was not affected by likelihood of contact with Covid-19-positive patients. Social isolation had a larger impact on mental health in the context of a previous psychiatric diagnosis. Face-to-face assessments were preferred. Conclusions: Rates of distress in doctors have been higher than baseline during Covid-19. Some groups have been particularly vulnerable.


2020 ◽  
Vol 15 (06) ◽  
pp. 269-275
Author(s):  
Kaila Lessner ◽  
Conrad Krawiec

AbstractWhen unrecognized and antibiotic delay occurs, Lyme disease, Rocky Mountain–spotted fever, babesiosis, and human ehrlichiosis and anaplasmosis can result in multiorgan system dysfunction and potentially death. This review focuses on the early recognition, evaluation, and stabilization of the rare life-threatening sequelae seen in tick-borne illnesses that require admission in the pediatric intensive care unit.


2014 ◽  
Vol 5 (2) ◽  
pp. 85-89 ◽  
Author(s):  
Anne M. Gadomski ◽  
Melissa B. Scribani ◽  
Nicole Krupa ◽  
Paul L. Jenkins

2021 ◽  
Vol 10 (14) ◽  
pp. 1045-1053
Author(s):  
Shuang Chen ◽  
Jamie C Barner ◽  
Eun Cho

Aim: To describe trends in off-label antipsychotic use among Texas Medicaid adults and examine whether demographic and clinical characteristics were associated with off-label use. Methods: Three diagnostic groups (i.e. no diagnosis, on label and off-label) were created based on mental health disorder diagnoses and related antipsychotic prescriptions. Results: During 2013–2016, the prevalence of off-label antipsychotic use decreased from 22.5% to 17.4% and the proportions of no mental health diagnosis remained stable (7.3–9.4%). Patients aged ≥25 years and second-generation antipsychotic users had significantly lower odds of receiving antipsychotics off-label or with no diagnosis. Conclusion: Compared with previous Medicaid database studies, the proportions of off-label antipsychotic use and antipsychotic use with no concurrent psychiatric diagnosis were notably lower.


1994 ◽  
Vol 5 (3) ◽  
pp. 289-295 ◽  
Author(s):  
Nancy E. Page ◽  
Nancy M. Boeing

Much controversy has arisen in the last few decades regarding parental and family visitation in the intensive care setting. The greatest needs of parents while their child is in an intensive care unit include: to be near their child, to receive honest information, and to believe their child is receiving the best care possible. The barriers that exist to the implementation of open visitation mostly are staff attitudes and misconceptions of parental needs. Open visitation has been found in some studies to make the health-care providers’ job easier, decrease parental anxiety, and increase a child’s cooperativeness with procedures. To provide family-centered care in the pediatric intensive care unit, the family must be involved in their child’s care from the day of admission. As health-care providers, the goal is to empower the family to be able to advocate and care for their child throughout and beyond the life crisis of a pediatric intensive care unit admission


2021 ◽  
Author(s):  
Zi-Hong Xiong ◽  
Xue-Mei Zheng ◽  
Guo-Ying Zhang ◽  
Meng-Jun Wu ◽  
Yi Qu

Abstract BackgroundMalnutrition is highly prevalent in critically ill children in the pediatric intensive care unit .We aimed to investigate the efficiency of bioelectrical impedance analysis (BIA) measurements and phase angle (PhA) analysis for the assessment of nutritional risk and clinical outcomes in critically ill children.MethodsThis single-center observational study included patients admitted to the Pediatric Intensive Care Unit (PICU) of Chengdu Women’s and Children’s Central Hospital. All patients underwent anthropometric measurement in the first 24 h of admission and underwent BIA measurements within 3 days after the admission. The patients were classified into different groups based on body mass index (BMI) for age. Electronic hospital medical records were reviewed to collect clinical data for each patient. All the obtained data were analyzed by the statistics method.ResultsThere were 204 patients enrolled in our study, of which 32.4% were diagnosed with malnutrition. We found that BMI, arm muscle circumference, fat mass, and %body fat were lower in the group with poorer nutritional status (P < 0.05). Evident differences in the score of the Pediatric Risk of Mortality and the duration of mechanical ventilation (MV) among the three groups with different nutritional statuses were observed (P < 0.05). Patients in the severely malnourished group had the longest duration of MV. In the MV groups, there were significant differences (P < 0.05) in albumin level, PhA, and extracellular water/total body water (ECW/TBW ratio). The ECW/TBW ratio and the time for PICU stay had a weak degree of correlation (Pearson correlation coefficient = 0.375). PhA showed a weak degree of correlation with the duration time of medical ventilation (coefficient of correlation = 0.398).ConclusionBIA can be considered an alternative way to assess nutritional status in critically ill children. ECW/TBW ratio and PhA were correlated with PICU stay and duration time of medical ventilation, respectively.


2020 ◽  
Author(s):  
Nazanin Andalibi ◽  
Madison K Flood

BACKGROUND Peer support is an approach to cope with mental illness, and technology provides a way to facilitate peer support. However, there are barriers to seeking support in offline and technology-mediated contexts. OBJECTIVE This study aims to uncover potential ways to design digital mental health peer support systems and to outline a set of principles for future designers to consider as they embark on designing these systems. By learning how existing systems are used by people in daily life and by centering their experiences, we can better understand how to design mental health peer support technologies that foreground people’s needs. One existing digital peer support system is Buddy Project, the case study in this paper. METHODS This paper reports on an interview study with Buddy Project users (N=13). Data were analyzed using the constant comparative approach. RESULTS Individuals matched through Buddy Project developed supportive friendships with one another, leading them to become each other’s peer supporters in their respective journeys. It was not only the mental health peer support that was important to participants but also being able to connect over other parts of their lives and identities. The design of Buddy Project provided a sense of anonymity and separation from pre-existing ties, making it easier for participants to disclose struggles; moreover, the pairs appreciated being able to browse each other’s social media pages before connecting. Buddy Project has an explicit mission to prevent suicide and demonstrates this mission across its online platforms, which helps reduce the stigma around mental health within the peer support space. Pairs were matched based on shared interests and identities. This choice aided the pairs in developing meaningful, compatible, and supportive relationships with each other, where they felt seen and understood. However, the pairs were concerned that matching based on a shared mental health diagnosis may lead to sharing unhealthy coping mechanisms or comparing themselves and the severity of their experiences with their peers. CONCLUSIONS The results of this study shed light on desirable features of a digital mental health peer support system: matching peers based on interests and identities that they self-identify with; having an explicit mental health–related mission coupled with social media and other web-based presences to signal that discussing mental health is safe within the peer support ecosystem; and not matching peers based on a broad mental health diagnosis. However, if the diagnosis is important, this matching should account for illness severity and educate peers on how to provide support while avoiding suggesting unhelpful coping mechanisms; allowing for some degree of anonymity and control over how peers present themselves to each other; and providing relevant information and tools to potential peers to help them decide if they would like to embark on a relationship with their matched peer before connecting with them. CLINICALTRIAL


2022 ◽  
Vol 226 (1) ◽  
pp. S361-S362
Author(s):  
Marcela Smid ◽  
Amanda A. Allshouse ◽  
Kristine Campbell ◽  
Michelle P. Debbink ◽  
Gerald Cochran

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