Post intensive care syndrome prevention and impact of COVID 19

2021 ◽  
Vol 11 (1) ◽  
pp. 112-117
Author(s):  
Dimitrios Alefragkis
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Sleep Problems ◽  
Care Plan ◽  
Prevention Measures ◽  
Post Traumatic Stress ◽  
Maximum Increase ◽  
Post Traumatic ◽  
The Impact ◽  
Post Intensive Care Syndrome

In recent years, there has been a maximum increase in admissions to the intensive care unit, culminating in an exponential increase in admissions during the COVID 19 pandemic. Many patients who survived and were discharged from the intensive care unit have cognitive, physical, and psychological disorders that are reflected in the term post-intensive care syndrome. Patients and their families show symptoms of anxiety, depression, post-traumatic stress, and sleep problems. The result is that they negatively affect their quality of life. Numerous risk factors contribute to the development of this syndrome, mainly the sedation, the duration of mechanical ventilation, and the length of stay in the intensive care unit. For this reason, it is necessary to take measures to prevent this syndrome including ABCDEFGH care plan, physical rehabilitation, nutritional support, and intensive care unit diaries. Care must also be given to the creation of Post Intensive care unit clinics where they have a diagnostic, therapeutic, counseling, and rehabilitation role that will act as assistants in the care of patients after discharge from the intensive care unit. Also, special care should be taken with patients who have recovered from COVID 19 whose needs are increasing and need immediate treatment. This review aims to analyze post-intensive care syndrome, prevention measures, and the impact of COVID 19. In conclusion, it is necessary to take measures to treat post-intensive care unit syndrome with early diagnosis and treatment, to reduce the adverse effects on both patients and their families.

scholarly journals Intensive Care Unit-Specific Virtual Reality for Psychological Recovery After ICU Treatment for COVID-19; A Brief Case Report

2021 ◽  
Vol 7 ◽  
Author(s):  
Johan H. Vlake ◽  
Jasper van Bommel ◽  
Merel E. Hellemons ◽  
Evert-Jan Wils ◽  
Diederik Gommers ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Virtual Reality ◽  
Intensive Care ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Post Traumatic Stress ◽  
Impact Of Event Scale ◽  
Event Scale ◽  
Post Traumatic ◽  
The Impact

A substantial number of ICU survivors are expected due to the SARS-CoV-2 outbreak, who are at risk for psychological impairments, such as post-traumatic stress disorder (PTSD), anxiety, and depression. We designed a COVID-19 intensive care unit-specific virtual reality (ICU-VR) intervention and tested it on one of our COVID-19 patients. The impact of event scale-revised and the hospital anxiety and depression scale showed that this patient suffered from PTSD, anxiety, and depression on the day of the intervention. One week after receiving ICU-VR, levels of PTSD, anxiety and depression had normalized, and stayed normalized until 6 months after discharge. In conclusion, innovative technologies, such as VR, have the potential to improve psychological rehabilitation, and should therefore be considered by clinicians for the treatment of ICU-related psychological sequelae after COVID-19.

scholarly journals Bereavement interventions to support informal caregivers in the intensive care unit: a systematic review

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Stephana J. Moss ◽  
Krista Wollny ◽  
Therese G. Poulin ◽  
Deborah J. Cook ◽  
Henry T. Stelfox ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Traumatic Stress ◽  
Critically Ill Patients ◽  
Informal Caregivers ◽  
Post Traumatic Stress ◽  
Bereavement Support ◽  
Complex Needs ◽  
Post Traumatic

Abstract Background Informal caregivers of critically ill patients in intensive care unit (ICUs) experience negative psychological sequelae that worsen after death. We synthesized outcomes reported from ICU bereavement interventions intended to improve informal caregivers’ ability to cope with grief. Data sources MEDLINE, EMBASE, CINAHL and PsycINFO from inception to October 2020. Study selection Randomized controlled trials (RCTs) of bereavement interventions to support informal caregivers of adult patients who died in ICU. Data extraction Two reviewers independently extracted data in duplicate. Narrative synthesis was conducted. Data synthesis Bereavement interventions were categorized according to the UK National Institute for Health and Clinical Excellence three-tiered model of bereavement support according to the level of need: (1) Universal information provided to all those bereaved; (2) Selected or targeted non-specialist support provided to those who are at-risk of developing complex needs; and/or (3) Professional specialist interventions provided to those with a high level of complex needs. Outcome measures were synthesized according to core outcomes established for evaluating bereavement support for adults who have lost other adults to illness. Results Three studies of ICU bereavement interventions from 31 ICUs across 26 hospitals were included. One trial examining the effect of family presence at brain death assessment integrated all three categories of support but did not report significant improvement in emotional or psychological distress. Two other trials assessed a condolence letter intervention, which did not decrease grief symptoms and may have increased symptoms of depression and post-traumatic stress disorder, and a storytelling intervention that found no significant improvements in anxiety, depression, post-traumatic stress, or complicated grief. Four of nine core bereavement outcomes were not assessed anytime in follow-up. Conclusions Currently available trial evidence is sparse and does not support the use of bereavement interventions for informal caregivers of critically ill patients who die in the ICU.

Post-traumatic stress symptoms in family caregivers of intensive care unit patients: A longitudinal study

2019 ◽  
Vol 50 ◽  
pp. 5-10 ◽  
Author(s):  
Hanne Birgit Alfheim ◽  
Kristin Hofsø ◽  
Milada Cvancarova Småstuen ◽  
Kirsti Tøien ◽  
Leiv Arne Rosseland ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Longitudinal Study ◽  
Family Caregivers ◽  
Traumatic Stress ◽  
Post Traumatic Stress ◽  
Stress Symptoms ◽  
Post Traumatic

scholarly journals Complicated grief after death of a relative in the intensive care unit

2015 ◽  
Vol 45 (5) ◽  
pp. 1341-1352 ◽  
Author(s):  
Nancy Kentish-Barnes ◽  
Marine Chaize ◽  
Valérie Seegers ◽  
Stéphane Legriel ◽  
Alain Cariou ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Complicated Grief ◽  
Depression Scale ◽  
Multivariate Logistic Regression Model ◽  
Post Traumatic Stress ◽  
Impact Of Event Scale ◽  
Event Scale ◽  
Loved One ◽  
Post Traumatic

An increased proportion of deaths occur in the intensive care unit (ICU).We performed this prospective study in 41 ICUs to determine the prevalence and determinants of complicated grief after death of a loved one in the ICU. Relatives of 475 adult patients were followed up. Complicated grief was assessed at 6 and 12 months using the Inventory of Complicated Grief (cut-off score >25). Relatives also completed the Hospital Anxiety and Depression Scale at 3 months, and the Revised Impact of Event Scale for post-traumatic stress disorder symptoms at 3, 6 and 12 months. We used a mixed multivariate logistic regression model to identify determinants of complicated grief after 6 months.Among the 475 patients, 282 (59.4%) had a relative evaluated at 6 months. Complicated grief symptoms were identified in 147 (52%) relatives. Independent determinants of complicated grief symptoms were either not amenable to changes (relative of female sex, relative living alone and intensivist board certification before 2009) or potential targets for improvements (refusal of treatment by the patient, patient died while intubated, relatives present at the time of death, relatives did not say goodbye to the patient, and poor communication between physicians and relatives).End-of-life practices, communication and loneliness in bereaved relatives may be amenable to improvements.

scholarly journals Psychological morbidity a year after treatment in intensive care unit

2020 ◽  
Vol 8 (3) ◽  
Author(s):  
George Zisopoulos ◽  
Pagona Roussi ◽  
Eleni Mouloudi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Low Income ◽  
Psychological Symptoms ◽  
Psychological Outcomes ◽  
Post Traumatic Stress ◽  
Social Constraint ◽  
Post Traumatic ◽  
Patients Experience

Several studies have linked treatment in the Intensive Care Unit (ICU) with negative psychological outcomes. This study explores the prevalence of negative psychological outcomes in Greek patients (N=29), a year after treatment in ICU. Percentages of participants with anxiety [41%, 95% CI (22%, 60%)] and Post- Traumatic Stress Disorder (PTSD) [34%, 95% CI (16%, 53%)] symptoms were similar to the related literature. Percentages of participants with depressive [17%, 95% CI (3%, 32%)] symptoms were rather low. Only 10% of participants reported absence of quality of live issues. Anxiety symptoms were related to desire to talk about the ICU experience (p=0.010), duration of propofol administration (p=0.018) and loss of employment (p=0.019) and negatively related to duration of stay in the ICU (p=0.025). PTSD symptoms were related to experiencing other stressors during the year after the ICU stay (p=0.001), social constraint (p=0.003), duration of propofol administration (p=0.004), loss of employment (p=0.020), low income (p=0.022) and negative ICU memories (p=0.029). Depressive symptoms were related to loss of employment (p=0.003), low income (p=0.029) and social constraint (p=0.033). Patients experience elevated levels of psychological symptoms long after they are discharged from the hospital. Several psychosocial factors emerged as important factors to consider for predicting levels of distress.

scholarly journals Protective effect of paramedics’ sense of personal accomplishment at work: Mitigating the impact of stress on sleep

2016 ◽  
Vol 13 (2) ◽  
Author(s):  
Charlotte Kukowski ◽  
David B King ◽  
Anita DeLongis
Keyword(s):  
Sleep Quality ◽  
Traumatic Stress ◽  
Sleep Problems ◽  
Maslach Burnout Inventory ◽  
Quality Standard ◽  
Personal Accomplishment ◽  
Poor Sleep ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
The Impact

IntroductionParamedics are at high risk for the development of post-traumatic stress disorder (PTSD), trauma-related symptoms, and burnout. Despite the multitude of research linking both PTSD and burnout with poor sleep quality, there has been no research linking all three variables, in emergency workers or otherwise. Given the importance of sleep in a profession that is largely reliant on shift work, the goal of the current study was to examine the moderating effect of burnout on the association between post-traumatic stress and average sleep quality. MethodsA sample of 87 paramedics from major urban centres across Canada completed the Maslach Burnout Inventory and the PTSD Checklist Civilian Version, in addition to reporting sleep quality for a period of one week. ResultsIn support of our hypotheses, post-traumatic stress was associated with lower average sleep quality. Standard regression analyses further revealed that this effect was moderated by burnout, such that higher burnout exacerbated the effect of post-traumatic stress on sleep. In examination of the subscales of the MBI, this effect was maintained for personal accomplishment only, which interacted with stress so as to further impair quality of sleep.ConclusionsThese findings offer important considerations regarding the mitigating role of more positive workplace variables in paramedics suffering from post-traumatic stress, PTSD, and/or sleep problems. Interventions aimed at fostering a sense of personal accomplishment on the job may improve the health of emergency medical personnel via multiple pathways.

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