Priorities for paediatric critical care research: a modified Delphi study by the Australian and New Zealand Intensive Care Society Paediatric Study Group

2021 ◽  
Vol 23 (2) ◽  
pp. 194-201
Author(s):  
Sainath *Raman ◽  
◽  
Georgia *Brown ◽  
*Equal first authors ◽  
Debbie Long ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Critical Care ◽  
Intensive Care ◽  
New Zealand ◽  
Delphi Study ◽  
Face To Face ◽  
Modified Delphi ◽  
Research Questions ◽  
Paediatric Critical Care

OBJECTIVE: Most interventions in paediatric critical care lack high grade evidence. We aimed to identify the key research priorities and key clinical outcome measures pertinent to research in paediatric intensive care patients. DESIGN: Modified three-stage Delphi study combining staged online surveys, followed by a face-to-face discussion and final voting. SETTING: Paediatric intensive care units in Australia and New Zealand. PARTICIPANTS: Medical and nursing staff working in intensive care. MAIN OUTCOME MEASUREMENTS: Self-reported priorities for research. RESULTS: 193 respondents provided a total of 267 research questions and 234 outcomes. In Stage 3, the top 56 research questions and 50 outcomes were discussed face to face, which allowed the identification of the top 20 research questions with the Hanlon prioritisation score and the top 20 outcomes. Topics centred on the use of intravenous fluids (restrictive v liberal fluids, use of fluid resuscitation bolus, early inotrope use, type of intravenous fluid, and assessment of fluid responsiveness), and patient- and family-centred outcomes (health-related quality of life, liberation) emerged as priorities. While mortality, length of stay, and organ support/organ dysfunction were considered important and the most feasible outcomes, long term quality of life and neurodevelopmental measures were rated highly in terms of their importance. CONCLUSIONS: Using a modified Delphi method, this study provides guidance towards prioritisation of research topics in paediatric critical care in Australia and New Zealand, and identifies study outcomes of key relevance to clinicians and experts in the field.

scholarly journals Erratum 1

2021 ◽  
Vol 23 (3) ◽  
pp. 242-242
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
New Zealand ◽  
Delphi Study ◽  
Study Group ◽  
Intensive Care Society ◽  
Care Society ◽  
Care Research ◽  
Paediatric Study ◽  
Paediatric Critical Care

Raman S, Brown G, Long D, et al; the Australian and New Zealand Intensive Care Society Paediatric Study Group (ANZICS PSG). Priorities for paediatric critical care research: a modified Delphi study by the Australian and New Zealand Intensive Care Society Paediatric Study Group. Crit Care Resusc 2021; 23: 194-201. In this article, on page 200, the Acknowledgements section should read: “We thank Mark Peters, University College London, UK, for sharing his expertise at the Hanlon stage of this exercise. The data team within the Paediatric Critical Care Research Group, Brisbane, Australia helped with the surveys and analyses of the data. We thank Kate Masterson, Royal Children’s Hospital Melbourne, and all staff from PICUs in Australia and New Zealand and the ANZICS PSG Committee who participated in this study. We acknowledge the local research coordinators and research staff, who assisted with study distribution, promotion and the prioritisation process.”

scholarly journals Professional Quality of Life in intensive care medicine: The 2018 Faculty of Intensive Care Medicine Workforce survey

2019 ◽  
Vol 21 (4) ◽  
pp. 299-304
Author(s):  
Julie Highfield ◽  
Jack Parry-Jones
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Medicine ◽  
Critical Care Medicine ◽  
Professional Quality Of Life ◽  
Survey Tool ◽  
Professional Quality

Background Critical care is widely perceived, both within and outside of the speciality, as unremitting and emotionally burdensome. There is a perception of a higher risk to medical staff of burnout than other specialities. Critical care also has considerable emotional and professional rewards. We sought to examine this balance between emotional reward and stress in UK critical care consultants registered with the Faculty of Intensive Care Medicine. Method We conducted a Wellbeing survey of the Faculty of Intensive Care Medicine consultant membership utilising the Professional Quality of Life (Pro-QOL) survey tool. The survey was conducted as part of the Annual Workforce Census. Results In sum, 799 members completed the Pro-QOL survey, making this one of the largest surveys of physician wellbeing in critical care medicine. Data were analysed in accordance with the Pro-QOL manual. Conclusions The results demonstrate moderate risk for burnout and secondary traumatic stress, but this is balanced by moderate compassion satisfaction. No association was demonstrated between age, sex, or size of critical care unit worked in. Further follow-up of this consultant group is warranted to better understand risk factors for burnout and for future mitigation of these risk factors whilst also enhancing the positive aspects of working as a consultant in critical care medicine.

scholarly journals Feasibility of Nurse-Led Multidimensional Outcome Assessments in the Neuroscience Intensive Care Unit

2020 ◽  
Vol 40 (3) ◽  
pp. e1-e8
Author(s):  
Erika Schlichter ◽  
Omar Lopez ◽  
Raymond Scott ◽  
Laura Ngwenya ◽  
Natalie Kreitzer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Neurocritical Care ◽  
Loss To Follow Up ◽  
Outcome Assessments ◽  
Neuroscience Intensive Care Unit

Background The outcome focus for survivors of critical care has shifted from mortality to patient-centered outcomes. Multidimensional outcome assessments performed in critically ill patients typically exclude those with primary neurological injuries. Objective To determine the feasibility of measurements of physical function, cognition, and quality of life in patients requiring neurocritical care. Methods This evaluation of a quality improvement initiative involved all patients admitted to the neuroscience intensive care unit at the University of Cincinnati Medical Center. Interventions Telephone assessments of physical function (Glasgow Outcome Scale-Extended and modified Rankin Scale scores), cognition (modified Telephone Interview for Cognitive Status), and quality of life (5-level EQ-5D) were conducted between 3 and 6 months after admission. Results During the 2-week pilot phase, the authors contacted and completed data entry for all patients admitted to the neuroscience intensive care unit over a 2-week period in approximately 11 hours. During the 18-month implementation phase, the authors followed 1324 patients at a mean (SD) time of 4.4 (0.8) months after admission. Mortality at follow-up was 38.9%; 74.8% of these patients underwent withdrawal of care. The overall loss to follow-up rate was 23.6%. Among all patients contacted, 94% were available by the second attempt to interview them by telephone. Conclusions Obtaining multidimensional outcome assessments by telephone across a diverse population of neurocritically ill patients was feasible and efficient. The sample was similar to those in other cohort studies in the neurocritical care population, and the loss to follow-up rate was comparable with that of the general critical care population.

Lung Transplantation

2015 ◽  
pp. 780-799
Author(s):  
Aaron M. Cheng ◽  
Michael S. Mulligan ◽  
Kei Togashi
Keyword(s):  
Quality Of Life ◽  
Critical Care ◽  
Intensive Care ◽  
Lung Function ◽  
Transplant Recipient ◽  
Lung Transplantation ◽  
Clinical Care ◽  
Critical Care Management ◽  
End Stage

Lung transplantation is a widely accepted surgical procedure for treatment of select patients suffering from end-stage lung disease. Recipients, however, require meticulous post-transplant care to preserve allograft lung function and to ensure optimal patient quality of life. In the post-operative period, these patients are predisposed to specific complications and pose unique considerations that clinicians caring for these patients in the intensive care setting should be familiar with managing. This chapter focuses on the early post-operative critical care management of the lung transplant recipient with specific emphasis on hemodynamic resuscitation; early lung graft dysfunction; and considerations regarding immunosuppression and infection. Non-pulmonary issues that affect the clinical care of these patients in the ICU setting are also discussed.

scholarly journals Quality of Life Outcome of Critical Care Survivors Eighteen Months after Discharge from Intensive Care

2007 ◽  
Vol 48 (6) ◽  
pp. 814-821 ◽  
Author(s):  
George Fildissis ◽  
Vasilios Zidianakis ◽  
Efi Tsigou ◽  
Despina Koulenti ◽  
Theofanis Katostaras ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Critical Care ◽  
Intensive Care

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 Assessment and health-related quality of life evaluation of critical care patients, 1 year after intensive care discharge

Critical Care ◽  
2009 ◽  
Vol 13 (Suppl 1) ◽  
pp. P518
Author(s):  
M Regueira ◽  
E Echavarria ◽  
L Ramos ◽  
E Alfonso ◽  
M Noya ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Critical Care ◽  
Intensive Care ◽  
Health Related Quality ◽  
Life Evaluation ◽  
Related Quality ◽  
Health Related ◽  
Critical Care Patients
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