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Post-icu syndrome

Silvio Simeone, Gianluca Pucciarelli, Marco Perrone, Teresa Rea, Gianpaolo Gargiulo, Assunta Guillari, Gaetano Castellano, Luigi Di Tommaso, Massimo Niola, Gabriele Iannelli
AIMS AND OBJECTIVES: To observe the clinical and structural factors that can be associated with the post-operative onset of delirium in patients who have undergone heart surgery. BACKGROUND: Several risk factors could contribute to the development of delirium, such as the use of some sedative drugs and a patient's history with certain types of acute chronic disease. However, in the literature, there is little knowledge about the association between delirium in patients who have undergone cardio-surgical intervention and their clinical and environmental predictors...
March 1, 2018: Journal of Clinical Nursing
Christiane S Hartog, Konrad Reinhart
PURPOSE OF REVIEW: End-of-life (EOL) care can be stressful for clinicians as well as patients and their relatives. Decisions to withhold or withdraw life-sustaining therapy vary widely depending on culture, beliefs and organizational norms. The following review will describe the current understanding of the problem and give an overview over interventional studies. RECENT FINDINGS: EOL care is a risk factor for clinician burnout; poor work conditions contribute to emotional exhaustion and intent to leave...
April 2018: Current Opinion in Anaesthesiology
Joanna L Stollings, Sarah L Bloom, Li Wang, E Wesley Ely, James C Jackson, Carla M Sevin
BACKGROUND: Many patients experience complications following critical illness; these are now widely referred to as post-intensive care syndrome (PICS). An interprofessional intensive care unit (ICU) recovery center (ICU-RC), also known as a PICS clinic, is one potential approach to promoting patient and family recovery following critical illness. OBJECTIVES: To describe the role of an ICU-RC critical care pharmacist in identifying and treating medication-related problems among ICU survivors...
February 1, 2018: Annals of Pharmacotherapy
G Umberto Meduri, Lisa Bridges, Reed A C Siemieniuk, Mehmet Kocak
OBJECTIVES: In the Acute Respiratory Distress Syndrome Network randomized controlled trial, methylprednisolone treatment was associated with increased return to mechanical ventilation with partial loss of early improvements. We hypothesize a causal relationship between protocol-driven rapid discontinuation of methylprednisolone post extubation and return to mechanical ventilation. To explore this possibility, we investigated the timing that events occurred in each treatment arm during active treatment intervention (efficacy) and after stopping therapy...
February 9, 2018: Critical Care Medicine
Joseph C Manning, Neethi P Pinto, Janet E Rennick, Gillian Colville, Martha A Q Curley
CONTEXT: Over the past several decades, advances in pediatric critical care have saved many lives. As such, contemporary care has broadened its focus to also include minimizing morbidity. Post Intensive Care Syndrome, also known as "PICS," is a group of cognitive, physical, and mental health impairments that commonly occur in patients after ICU discharge. Post Intensive Care Syndrome has been well-conceptualized in the adult population but not in children. OBJECTIVE: To develop a conceptual framework describing Post Intensive Care Syndrome in pediatrics that includes aspects of the experience that are unique to children and their families...
February 5, 2018: Pediatric Critical Care Medicine
Farshid R Bashar, Amir Vahedian-Azimi, Mahmood Salesi, Mohammadreza Hajiesmaeili, Seyedpouzhia Shojaei, Behrooz Farzanegan, Reza Goharani, Seyed J Madani, Kivan G Moghaddam, Sevak Hatamian, Hosseinali J Moghaddam, Abilio Arrascaeta-Llanes, Andrew C Miller
The aim of the present study is to describe how religiosity and spirituality affect the psychiatric morbidity of Muslim intensive care unit (ICU) patients. We conducted a prospective nationwide cross-sectional study of ICU patients discharged from 45 medical centers spanning 31 proivinces in Iran. Adults (age ≥ 18 years) admitted to the ICU and treated with invasive mechanical ventilation were eligible. Nine validated survey tools were administered to detect direct and indirect associations between spiritual health (SH) and depression, anxiety, and post-traumatic disorder...
January 3, 2018: Journal of Religion and Health
Shuofei Yang, Jianming Guo, Qihong Ni, Jiaquan Chen, Xiangjiang Guo, Guanhua Xue, Meng Ye, Lan Zhang
BACKGROUND: Little data evaluate the enteral nutrition (EN) for patients with acute mesenteric ischaemia (AMI) in the intensive care unit (ICU). This study assessed the outcomes of EN for recanalised AMI patients in the ICU. METHODS: In this retrospective study, 183 AMI patients with mesenteric recanalisation admitted to two surgical ICUs were included. Patients were divided into EN (EN within first week, n = 95) and total parenteral nutrition (TPN) group (TPN in 1st week, n = 88)...
December 20, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
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
Amir Vahedian-Azimi, Mohammadreza Hajiesmaeili, Mari Kangasniemi, Joana Fornés-Vives, Rita L Hunsucker, Farshid Rahimibashar, Mohammad A Pourhoseingholi, Leily Farrokhvar, Andrew C Miller
BACKGROUND: Health care is a demanding field, with a high level of responsibility and exposure to emotional and physical danger. High levels of stress may result in depression, anxiety, burnout syndrome, and in extreme cases, post-traumatic stress disorder. The aim of this study was to determine which personal, professional, and organizational variables are associated with greater perceived stress among critical care nurses for purposes of developing integrative solutions to decrease stress in the future...
January 1, 2017: Journal of Intensive Care Medicine
Pirkka T Pekkarinen, Giuseppe Ristagno, Erika Wilkman, Serge Masson, Roberto Latini, Johanna Laurikkala, Stepani Bendel, Tero Ala-Kokko, Tero Varpula, Jukka Vaahersalo, Sari Karlsson, Marjaana Tiainen, Monica M Mion, Mario Plebani, Ville Pettilä, Markus B Skrifvars
BACKGROUND: Patients resuscitated from cardiac arrest commonly develop an inflammatory response called post-cardiac arrest syndrome that clinically resembles septic shock.Procalcitonin and presepsin are associated with inflammation. We hypothesized that these biomarkers reflect the severity of post-cardiac arrest syndrome and predict short-term haemodynamical instability and long-term neurological outcome after cardiac arrest. METHODS: As a subcohort analysis of a prospective, observational, multi-centre study "FINNRESUSCI", we obtained plasma from 277 intensive care unit (ICU) patients treated following out-of-hospital cardiac arrest (OHCA)...
December 14, 2017: Shock
Thomas Bein, Steffen Weber-Carstens, Christian Apfelbacher
PURPOSE OF REVIEW: To review the current research data on long-term outcome and health-related quality of life in survivors of the acute respiratory distress syndrome (ARDS) and to compare these findings with those from non-ARDS patients surviving critical illness. RECENT FINDINGS: Between 6 months and 2 years after discharge from ICU, survivors of ARDS present with substantial impairments of the levels of body function (muscle strength, walking capacity and/or physical activity (physical SF-36 score)...
February 2018: Current Opinion in Critical Care
Joanne McPeake, Martin Shaw, Theodore J Iwashyna, Malcolm Daniel, Helen Devine, Lyndsey Jarvie, John Kinsella, Pamela MacTavish, Tara Quasim
BACKGROUND: Many patients suffer significant physical, social and psychological problems in the months and years following critical care discharge. At present, there is minimal evidence of any effective interventions to support this patient group following hospital discharge. The aim of this project was to understand the impact of a complex intervention for ICU survivors. METHODS: Quality improvement project conducted between September 2014 and June 2016, enrolling 49 selected patients from one ICU in Scotland...
2017: PloS One
Maïté Garrouste-Orgeas, Cécile Flahault, Léonor Fasse, Stéphane Ruckly, Nora Amdjar-Badidi, Laurent Argaud, Julio Badie, Amélie Bazire, Naike Bige, Eric Boulet, Lila Bouadma, Cédric Bretonnière, Bernard Floccard, Alain Gaffinel, Xavier de Forceville, Hubert Grand, Rebecca Halidfar, Olfa Hamzaoui, Mercé Jourdain, Paul-Henri Jost, Eric Kipnis, Audrey Large, Alexandre Lautrette, Olivier Lesieur, Virginie Maxime, Emmanuelle Mercier, Jean Paul Mira, Yannick Monseau, Erika Parmentier-Decrucq, Jean-Philippe Rigaud, Antoine Rouget, François Santoli, Georges Simon, Fabienne Tamion, Nathalie Thieulot-Rolin, Marina Thirion, Sandrine Valade, Isabelle Vinatier, Christel Vioulac, Sebastien Bailly, Jean-François Timsit
BACKGROUND: Post-intensive care syndrome includes the multiple consequences of an intensive care unit (ICU) stay for patients and families. It has become a new challenge for intensivists. Prevention programs have been disappointing, except for ICU diaries, which report the patient's story in the ICU. However, the effectiveness of ICU diaries for patients and families is still controversial, as the interpretation of the results of previous studies was open to criticism hampering an expanded use of the diary...
November 15, 2017: Trials
Wytske Geense, Marieke Zegers, Hester Vermeulen, Mark van den Boogaard, Johannes van der Hoeven
INTRODUCTION: Due to advances in critical care medicine, more patients survive their critical illness. However, intensive care unit (ICU) survivors often experience long-term physical, cognitive and mental problems, summarised as post-intensive care syndrome (PICS), impacting their health-related quality of life (HRQoL). In what frequency PICS occurs, and to what extent this influences ICU survivors' HRQoL, is mostly unknown. The aims of this study are therefore to study the: (1) 5-year patient outcomes, (2) predictors for PICS, (3) ratio between HRQoL of ICU survivors and healthcare-related costs, and (4) care and support needs...
November 14, 2017: BMJ Open
Ceri E Battle, Karen James, Tom Bromfield, Paul Temblett
Purpose: Post-traumatic stress disorder has been reported in survivors of critical illness. The aim of this study was to investigate the predictors of post-traumatic stress disorder in survivors of critical illness. Materials and methods: Patients attending the intensive care unit (ICU) follow-up clinic completed the UK-Post-Traumatic Stress Syndrome 14-Questions Inventory and data was collected from their medical records. Predictors investigated included age, gender, Apache II score, ICU length of stay, pre-illness psychopathology; delirium and benzodiazepine administration during ICU stay and delusional memories of the ICU stay following discharge...
November 2017: Journal of the Intensive Care Society
Tilde Skovkær Withen Olesen, Mary Kruse, Malgorzata Pawlowicz-Dworzanska, Kirsten Klostergaard, Peter Derek Christian Leutscher
Patients surviving severe critical illness commonly develop post intensive care syndrome (PICS). The syndrome consists of a constellation of cognitive dysfunction, depression, anxiety and post-traumatic stress disorder combined with physical weakness. Different contributing risk factors for development of PICS have been identified. Furthermore, close family members of the patient are at risk of developing similar psychiatric manifestations. Focus should be on early preventive measures during hospitalization and post-ICU follow-up with a multidisciplinary approach...
November 6, 2017: Ugeskrift for Laeger
Daniel Haines, Johanna Hild, Jianghua He, Lucy Stun, Angie Ballew, Justin L Green, Lewis Satterwhite, Brigid C Flynn
Post-ICU Syndromes (PICS) remain a devastating problem for intensive care unit (ICU) survivors. It is currently unknown if de novo initiation of an antidepressant medication during ICU stay decreases the prevalence of post-ICU depression. We performed a retrospective, pilot study evaluating patients who had not previously been on an antidepressant medication and who were started on an antidepressant while in the trauma surgical, cardiothoracic, or medical intensive care unit (ICU). The PHQ-2 depression scale was used to ascertain the presence of depression after ICU discharge and compared this to historical controls...
2017: Critical Care Research and Practice
Ariane R Panzer, Susan V Lynch, Chaz Langelier, Jason D Christie, Kathryn McCauley, Mary Nelson, Christopher K Cheung, Neal L Benowitz, Mitchell J Cohen, Carolyn S Calfee
RATIONALE: Cigarette smoking is associated with increased risk of acute respiratory distress syndrome (ARDS) in patients after severe trauma; however, the mechanisms underlying this association are unknown. OBJECTIVES: To determine whether cigarette smoking contributes to ARDS development after trauma by altering community composition of the lung microbiota. METHODS: We studied the lung microbiota of mechanically ventilated patients admitted to the ICU after severe blunt trauma...
March 1, 2018: American Journal of Respiratory and Critical Care Medicine
Hao Wang, Na Cui, Fang Niu, Hongying Xu, Yun Long, Dawei Liu
OBJECTIVE: To determine the value of procalcitonin (PCT) as an early marker of postoperative infection after cardiac surgery with cardiopulmonary bypass (CPB). METHODS: A retrospective study was conducted. Patients with systemic inflammatory response syndrome (SIRS) after cardiac surgery with CPB admitted to intensive care unit (ICU) of Peking Union Medical College Hospital from November 2014 to January 2017 were enrolled. The cardiac surgery types and intraoperative conditions, the treatments in ICU, postoperative 28-day mortality and hospital mortality of the patients; the levels of plasma PCT measured at ICU admission, postoperative 1, 3, and 5 days were collected...
October 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Sophia Wang, Chris Mosher, Anthony J Perkins, Sujuan Gao, Sue Lasiter, Sikandar Khan, Malaz Boustani, Babar Khan
The prevalence of psychiatric symptoms ranges from 17% to 44% in intensive care unit (ICU) survivors. The relationship between the comorbidity of psychiatric symptoms and quality of life (QoL) in ICU survivors has not been carefully examined. This study examined the relationship between psychiatric comorbidities and QoL in 58 survivors of ICU delirium. Patients completed 3 psychiatric screens at 3 months after discharge from the hospital, including the Patient Health Questionnaire-9 (PHQ-9) for depression, the Generalized Anxiety Disorder-7 (GAD-7) questionnaire for anxiety, and the Post-Traumatic Stress Syndrome (PTSS- 10) questionnaire for posttraumatic stress disorder...
October 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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