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quality of life after critical illness

Annemieke Oude Lansink-Hartgring, Dinis Dos Reis Miranda, Dirk W Donker, Jacinta J Maas, Thijs Delnoij, Marijn Kuijpers, Judith van den Brule, Erik Scholten, Hendrik Endeman, Alexander P J Vlaar, Walter M van den Bergh
BACKGROUND: Extracorporeal life support (ECLS) is used to support the cardiorespiratory function in case of severe cardiac and/or respiratory failure in critically ill patients. According to the ELSO guidelines ECLS should be considered when estimated mortality risk approximates 80%. ECLS seems an efficient therapy in terms of survival benefit, but no undisputed evidence is delivered yet. The aim of the study is to assess the health-related quality of life after ECLS treatment and its cost effectiveness...
March 9, 2018: BMC Health Services Research
W Philip T James
BACKGROUND: This analysis sets out an overview of an IUNS presentation of a European clinician's assessment of the challenges of coping with immediate critical clinical problems and how to use metabolic and a mechanistic understanding of disease when developing nutritional policies. SUMMARY: Critically ill malnourished children prove very sensitive to both mineral and general nutritional overload, but after careful metabolic control they can cope with a high-quality, energy-rich diet provided their initial lactase deficiency and intestinal atrophy are taken into account...
March 8, 2018: Annals of Nutrition & Metabolism
John Grundy, Kon Mouzakis, Rajesh Vasa, Andrew Cain, Maheswaree Curumsing, Mohamed Abdelrazek, Niroshine Fernando
By the 2050, it is estimated that the proportion of people over the age of 80 will have risen from 3.9% to 9.1% of population of Organisation for Economic Cooperation and Development countries. A large proportion of these people will need significant help to manage various chronic illnesses, including dementia, heart disease, diabetes, limited physical movement and many others. Current approaches typically focus on acute episodes of illness and are not well designed to provide adequately for daily living care support...
2018: Studies in Health Technology and Informatics
Rajesh M Shetty, Antonio Bellini, Dhuleep S Wijayatilake, Mark A Hamilton, Rajesh Jain, Sunil Karanth, ArunKumar Namachivayam
BACKGROUND: Patients admitted to intensive care and on mechanical ventilation, are administered sedative and analgesic drugs to improve both their comfort and interaction with the ventilator. Optimizing sedation practice may reduce mortality, improve patient comfort and reduce cost. Current practice is to use scales or scores to assess depth of sedation based on clinical criteria such as consciousness, understanding and response to commands. However these are perceived as subjective assessment tools...
February 21, 2018: Cochrane Database of Systematic Reviews
Gloria-Beatrice Wintermann, Jenny Rosendahl, Kerstin Weidner, Bernhard Strauß, Andreas Hinz, Katja Petrowski
BACKGROUND: Fatigue often occurs as long-term complication in chronically critically ill (CCI) patients after prolonged intensive care treatment. The Multidimensional Fatigue Inventory (MFI-20) has been established as valid instrument to measure fatigue in a wide range of medical illnesses. Regarding the measurement of fatigue in CCI patients, the psychometric properties of the MFI-20 have not been investigated so far. Thus, the present study examines reliability and validity of the MFI-20 in CCI patients...
February 20, 2018: Health and Quality of Life Outcomes
Diane M Mackle, Michael J Bailey, Richard W Beasley, Rinaldo Bellomo, Victoria L Bennett, Adam M Deane, Glenn M Eastwood, Simon Finfer, Ross C Freebairn, Edward Litton, Natalie J Linke, Colin J McArthur, Shay P McGuinness, Rakshit Panwar, Paul J Young
BACKGROUND: The balance of risks and benefits of conservative v standard care oxygen strategies for patients who are invasively ventilated in the intensive care unit (ICU) is uncertain. OBJECTIVE: To describe the study protocol and statistical analysis plan for the ICU randomised trial comparing two approaches to oxygen therapy (ICU-ROX). DESIGN, SETTING AND PARTICIPANTS: Protocol for a multicentre, randomised, participant and outcome assessor-blinded, standard care-controlled, parallel-group, two-sided superiority trial to be conducted in up to 22 ICUs in Australia and New Zealand...
March 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
(no author information available yet)
BACKGROUND: Nutrition is routinely provided to critically ill patients who are mechanically ventilated and remain in the intensive care unit for more than a few days. Nasogastric feeding, which is standard practice for patients who are unable to tolerate oral nutrition, typically delivers less than 60% of the recommended energy requirements. It remains uncertain whether the delivery of about 100% of the recommended energy goals via the enteral route will affect survival and other important clinical outcomes...
March 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
Sikandar Khan, Ashok Biju, Sophia Wang, Sujuan Gao, Omar Irfan, Amanda Harrawood, Stephanie Martinez, Emily Brewer, Anthony Perkins, Frederick W Unverzagt, Sue Lasiter, Ben Zarzaur, Omar Rahman, Malaz Boustani, Babar Khan
BACKGROUND: Patients admitted to intensive care units (ICU) with acute respiratory failure (ARF) face chronic complications that can impede return to normal daily function. A mobile, collaborative critical care model may enhance the recovery of ARF survivors. METHODS: The Mobile Critical Care Recovery Program (m-CCRP) study is a two arm, randomized clinical trial. We will randomize 620 patients admitted to the ICU with acute respiratory failure requiring mechanical ventilation in a 1:1 ratio to one of two arms (310 patients per arm) - m-CCRP intervention versus attention control...
February 7, 2018: Trials
Varinder K Randhawa, Brian E Grunau, Derek B Debicki, Jian Zhou, Ahmed F Hegazy, Terry McPherson, A Dave Nagpal
Survival with a good quality of life after cardiac arrest continues to be abysmal. Coordinated resuscitative care does not end with the effective return of spontaneous circulation (ROSC)-in fact, quite the contrary is true. Along with identifying and appropriately treating the precipitating cause, various components of the post-cardiac arrest syndrome also require diligent observation and management, including post-cardiac arrest neurologic injury and myocardial dysfunction, systemic ischemia-reperfusion phenomenon with potential consequent multiorgan failure, and the various sequelae of critical illness...
February 2018: Canadian Journal of Cardiology
Courtney Merritt, Kusum Menon, Michael S D Agus, Karen Choong, Dayre McNally, Katie O'Hearn, R Scott Watson, Hector R Wong, Mark Duffett, David Wypij, Jerry J Zimmerman
OBJECTIVES: To identify, in addition to survival, preferred outcome measures of PICU family care providers and PICU healthcare professionals for interventional trials enrolling critically ill children, and to describe general attitudes of family care providers and healthcare professionals regarding research in the PICU. DESIGN: Cross-sectional survey examining subject experience with clinical research and personal preferences for outcome measures for a hypothetical interventional clinical trial...
February 2018: Pediatric Critical Care Medicine
Karen Choong, Douglas Fraser, Samah Al-Harbi, Asm Borham, Jill Cameron, Saoirse Cameron, Ji Cheng, Heather Clark, Tim Doherty, Nora Fayed, Jan-Willem Gorter, Margaret Herridge, Mary Khetani, Kusum Menon, Jamie Seabrook, Racquel Simpson, Lehana Thabane
OBJECTIVES: To evaluate functional outcomes and evaluate predictors of an unfavorable functional outcome in children following a critical illness. DESIGN: Prospective observational longitudinal cohort study. SETTING: Two tertiary care, Canadian PICUs: McMaster Children's Hospital and London Health Sciences. PATIENTS: Children 12 months to 17 years old, admitted to PICU for at least 48 hours with one or more organ dysfunction, were eligible...
February 2018: Pediatric Critical Care Medicine
Line Toft Tengberg
Critically ill acute high-risk abdominal surgery patients represent a major challenge to health care providers, with the typical patient being elderly and frail, and with severe and multiple comorbidities. The mortality rate in this population is high, and the postoperative course is characterized by complications, prolonged hospitalisation and considerable risk of permanent disability. With an ageing population, the number of elderly patients, as well as challenges concerning treatment will arise, calling for a coordinated effort both nationally and internationally to enhance treatment in this vulnerable patient group...
February 2018: Danish Medical Journal
Corinne Urech, Astrid Grossert, Judith Alder, Sandra Scherer, Barbara Handschin, Benjamin Kasenda, Borislava Borislavova, Sven Degen, Jennifer Erb, Alexandra Faessler, Laura Gattlen, Sarah Schibli, Celine Werndli, Jens Gaab, Thomas Berger, Thomas Zumbrunn, Viviane Hess
Purpose Being diagnosed with cancer causes major psychological distress; however, a majority of patients lack psychological support during this critical period. Internet interventions help patients overcome many barriers to seeking face-to-face support and may thus close this gap. We assessed feasibility and efficacy of Web-based stress management (STREAM [Stress-Aktiv-Mindern]) for newly diagnosed patients with cancer. Patients and Methods In a randomized controlled trial, patients with cancer who had started first-line treatment within the previous 12 weeks were randomly assigned to a therapist-guided Web-based intervention or a wait-list (control), stratified according to distress level (≥ 5 v < 5 on scale of 0 to 10)...
January 25, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Maria Vargas, Yuda Sutherasan, Iole Brunetti, Camilla Micalizzi, Angelo Insorsi, Lorenzo Ball, Marta Folentino, Rosanna Sileo, Arduino DE Lucia, Manuela Cerana, Alessandro Accattatis, Domenico DE Lisi, Angelo Gratarola, Francesco Mora, Giorgio Peretti, Giuseppe Servillo, Paolo Pelosi
BACKGROUND: Quality of life and mortality after percutaneous dilatational tracheotomy (PDT) has been poorly investigated. The aims of this study were to evaluate the independent risk factors for Intensive Care Unit (ICU) mortality and investigate quality of life over the first year after PDT in critically ill patients. METHODS: This was a prospective, single-center, cohort study performed in a tertiary care University Hospital, enrolling consecutive ICU patients requiring elective PDT, collecting data during the tracheotomy procedure and the ICU stay...
January 16, 2018: Minerva Anestesiologica
Phillippa K Bailey, Alexander J Hamilton, Rhian L Clissold, Carol D Inward, Fergus J Caskey, Yoav Ben-Shlomo, Amanda Owen-Smith
INTRODUCTION: Young adults fare worse than younger adolescents or older adults on a broad range of health indicators. Those with a chronic illness such as renal failure are a particularly vulnerable group, who experience poor outcomes compared with both children and older adults. Understanding how being in receipt of renal replacement therapy (RRT) affects the lives of young adults might help us to better prepare and support these individuals for and on RRT, and improve outcomes. This study aimed to synthesise research describing young adults' experiences of the psychosocial impact of kidney failure and RRT...
January 10, 2018: BMJ Open
João Apóstolo, Richard Cooke, Elzbieta Bobrowicz-Campos, Silvina Santana, Maura Marcucci, Antonio Cano, Miriam Vollenbroek-Hutten, Federico Germini, Barbara D'Avanzo, Holly Gwyther, Carol Holland
OBJECTIVE: To summarize the best available evidence regarding the effectiveness of interventions for preventing frailty progression in older adults. INTRODUCTION: Frailty is an age-related state of decreased physiological reserves characterized by an increased risk of poor clinical outcomes. Evidence supporting the malleability of frailty, its prevention and treatment, has been presented. INCLUSION CRITERIA: The review considered studies on older adults aged 65 and over, explicitly identified as pre-frail or frail, who had been undergoing interventions focusing on the prevention of frailty progression...
January 2018: JBI Database of Systematic Reviews and Implementation Reports
Péricles A D Duarte, Jaquilene Barreto Costa, Silvana Trilo Duarte, Sheila Taba, Claudia Regina Felicetti Lordani, Erica Fernanda Osaku, Claudia Rejane Lima Macedo Costa, Dalas Cristina Miglioranza, Daniela Prochnow Gund, Amaury Cesar Jorge
OBJECTIVES: To describe the experience of an outpatient clinic with the multidisciplinary evaluation of intensive care unit survivors and to analyze their social, psychological, and physical characteristics in a low-income population and a developing country. METHODS: Retrospective cohort study. Adult survivors from a general intensive care unit were evaluated three months after discharge in a post-intensive care unit outpatient multidisciplinary clinic over a period of 6 years (2008-2014) in a University Hospital in southern Brazil...
December 2017: Clinics
S E Giannasi, M S Venuti, A D Midley, N Roux, C Kecskes, E San Román
OUTCOME: To determine mortality prognostic factors in elderly patients who are admitted to intensive care units (ICUs) due to acute critical illness. DESIGN: A prospective cohort study was carried out. SETTING: A polyvalent Intensive Care Unit at a University Hospital in Argentina. PATIENTS OR PARTICIPANTS: We included 249 patients over 65years of age who were consecutively admitted to the ICU and required mechanical ventilation for more than 48hours, between January 2011 and December 2012...
December 27, 2017: Medicina Intensiva
Amy B Petrinec, Bradley R Martin
OBJECTIVE: Family members of critically ill patients can suffer symptoms of post-intensive care syndrome-family (PICS-F), including anxiety, depression, and posttraumatic stress disorder (PTSD) with a diminished quality of life. Our aim was to examine the relationship between coping strategies used by family decision-makers (FDMs) of critically ill patients and the severity of PICS-F symptoms and to examine the relationship between FDM PICS-F symptoms and health-related quality of life (HRQOL)...
December 26, 2017: Palliative & Supportive Care
Kathleen L Grady, Philip G Jones, Adin Cristian-Andrei, David C Naftel, Susan Myers, Mary Amanda Dew, Katharine Idrissi, Gerdi Weidner, Sherri A Wissman, James K Kirklin, John A Spertus
BACKGROUND: Missing health-related quality of life (HRQOL) data in longitudinal studies can reduce precision and power and bias results. Using INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support), we sought to identify factors associated with missing HRQOL data, examine the impact of these factors on estimated HRQOL assuming missing at random missingness, and perform sensitivity analyses to examine missing not at random (MNAR) missingness because of illness severity...
December 2017: Circulation. Cardiovascular Quality and Outcomes
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