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Icu depression

Ryan C Dillon, Jose-Alberto Palma, Christy L Spalink, Diana Altshuler, Lucy Norcliffe-Kaufmann, David Fridman, John Papadopoulos, Horacio Kaufmann
OBJECTIVE: Adrenergic crises are a cardinal feature of familial dysautonomia (FD). Traditionally, adrenergic crises have been treated with the sympatholytic agent clonidine or with benzodiazepines, which can cause excessive sedation and respiratory depression. Dexmedetomidine is a centrally-acting α 2-adrenergic agonist with greater selectivity and shorter half-life than clonidine. We evaluated the preliminary effectiveness and safety of intravenous dexmedetomidine in the treatment of refractory adrenergic crisis in patients with FD...
October 17, 2016: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
Janet F Jensen, Ingrid Egerod, Morten H Bestle, Doris F Christensen, Ask Elklit, Randi L Hansen, Heidi Knudsen, Louise B Grode, Dorthe Overgaard
PURPOSE: The aim of this randomized controlled trial (RCT) was to test the effectiveness of a post-ICU recovery program compared to standard care during the first year after ICU discharge. METHODS: A pragmatic, non-blinded, multicenter, parallel-group RCT was conducted between December 2012 and December 2015, at ten intensive care units (ICUs) in Denmark. We randomly assigned 386 adult patients (≥18 years) after receiving mechanical ventilation (≥48 h) to standard care (SC) plus a nurse-led intensive care recovery program or standard care alone after ICU discharge (190 intervention, 196 SC)...
September 30, 2016: Intensive Care Medicine
Vico Chung Lim Chiang, Wai Tong Chien, Ho Ting Wong, Rainbow Lai Ping Lee, Juana Ha, Sharron Shuk Kam Leung, Daniel Fu Keung Wong
Having a loved one in the intensive care unit (ICU) is a stressful event, which may cause a high level of anxiety to the family members. This could threaten their wellbeing and ability to support the patients in, or after discharge from, the ICU. To investigate the outcomes of a brief cognitive-behavioral psycho-education program (B-CBE) to manage stress and anxiety of the main family caregivers (MFCs), a pragmatic quasi-experimental study involving 45 participants (treatment group: 24; control group: 21) was conducted in an ICU...
2016: International Journal of Environmental Research and Public Health
Rosa M Roche, Dorothy Brooten, JoAnne M Youngblut
BACKGROUND: Understanding children's health after a sibling's death and what factors may affect it is important for treatment and clinical care. This study compared children's and their parents' perceptions of children's health and identified relationships of children's age, gender, race/ethnicity, anxiety, and depression and sibling's cause of death to these perceptions at 2 and 4 months after sibling death. METHODS: 64 children and 48 parents rated the child's health "now" and "now vs before" the sibling's death in an ICU or ER or at home shortly after withdrawal of life-prolonging technology...
2016: Int J Nurs Clin Pract
Stéphanie Malaquin, Yazine Mahjoub, Arianna Musi, Elie Zogheib, Alexis Salomon, Mathieu Guilbart, Hervé Dupont
INTRODUCTION: There has been a growing interest in evaluating the occurrence of burnout syndrome (BOS) among intensive care units (ICU) team over recent years. The aims of this study were to determine the prevalence of BOS among staff working in the Amiens University Hospital and to assess associated factors. PATIENTS AND METHODS: Prospective observational study based on self-administered questionnaires filled in by physicians and non-physicians working in 3 ICUs...
September 23, 2016: Anaesthesia, Critical Care & Pain Medicine
Changli DU
BACKGROUND: Our aim was to forward an effective therapeutic approach by comparing efficacy and psychological states between patients with senile ischemic heart failure undergone ICU and conventional therapies. METHODS: We selected 64 patients from Hospital of Traditional Chinese Medicine of Rizhao (Shandong, China) between June 2013 and June 2014. The patients had ischemic heart disease, and were monitored for one-year time span. They were randomly divided into the experiment and control group, each of which of 32 cases...
June 2016: Iranian Journal of Public Health
Tomasz Gaszynski
INTRODUCTION: We report on the anesthetic management using opioid-free method of a patient with Steinert syndrome (myotonic dystrophy, MD), autosomal dominant dystrophy which is characterized by consistent contracture of muscle following stimulation. A myotonic crisis can be induced by numerous factors including hypothermia, shivering, and mechanical or electrical stimulation. In patients with MD, hypersensitivity to anesthetic drugs, especially muscle relaxants and opioids, may complicate postoperative management...
September 2016: Medicine (Baltimore)
Jonathan Messika, David Hajage, Nataly Panneckoucke, Serge Villard, Yolaine Martin, Emilie Renard, Annie Blivet, Jean Reignier, Natacha Maquigneau, Annabelle Stoclin, Christelle Puechberty, Stéphane Guétin, Aline Dechanet, Amandine Fauquembergue, Stéphane Gaudry, Didier Dreyfuss, Jean-Damien Ricard
BACKGROUND: Non-invasive ventilation (NIV) tolerance is a key factor of NIV success. Hence, numerous sedative pharmacological or non-pharmacological strategies have been assessed to improve NIV tolerance. Music therapy in various health care settings has shown beneficial effects. In invasively ventilated critical care patients, encouraging results of music therapy on physiological parameters, anxiety, and agitation have been reported. We hypothesize that a musical intervention improves NIV tolerance in comparison to conventional care...
2016: Trials
Finn H Andersen, Hans Flaatten, Pål Klepstad, Turid Follestad, Kristian Strand, Andreas J Krüger, Michael Hahn, Christian Buskop, Anne-Karin Rime, Reidar Kvåle
OBJECTIVE: To describe ICU admission triage and outcomes in octogenarians. DESIGN: Multicenter prospective observational study. SETTING: Three nonuniversity hospitals and three university hospitals in Norway. PATIENTS: Patients 80 years old or older who were referred for ICU admission from November 2013 to October 2014. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of the 355 included patients, 105 (29...
September 9, 2016: Critical Care Medicine
Joao Gabriel Rosa Ramos, Mario Diego Teles Correa, Ricardo Tavares de Carvalho, Daryl Jones, Daniel Neves Forte
PURPOSE: To evaluate clinical characteristics of patients with palliative care (PC) and urgent intensive care unit (ICU) referrals in the same hospital admission. METHODS: All urgent ICU referrals at an academic, tertiary hospital, and the co-occurrence and timing of PC assessment were retrieved from a prospectively collected database. RESULTS: From May 2014 to May 2015, 2476 patients were analyzed and 179 (7%) had co-occurrence of PC assessment and urgent ICU referral in the same hospital admission...
August 21, 2016: Journal of Critical Care
Kelly M Shaffer, Eric Riklin, Jamie M Jacobs, Jonathan Rosand, Ana-Maria Vranceanu
PURPOSE: The purpose of the study is to examine the associations of patients' and their informal caregivers' psychosocial resiliency factors with their own and their partners' emotion domains (distress, anxiety, depression, and anger) after admission to the neuroscience intensive care unit (Neuro-ICU). MATERIALS AND METHODS: Eighty-three dyads of patients (total n = 87) and their informal caregivers (total n = 99) participated in this observational, cross-sectional study by self-reporting demographics and measures of resiliency factors (mindfulness [Cognitive and Affective Mindfulness Scale Revised], coping [Measure of Coping Status-A], intimate bond [Intimate Bond Measure], self-efficacy [patients: General Self-Efficacy Scale; caregivers: Revised Caregiver Self-Efficacy Scale]) and emotion domains (Emotion Thermometers) within 2 weeks of Neuro-ICU admission...
July 16, 2016: Journal of Critical Care
Kate Kynoch, Anne Chang, Fiona Coyer, Annie McArdle
BACKGROUND: Attending to the needs of family members of critically ill patients is an important and necessary step in providing appropriate holistic care for both the patient and the family. Family interaction can significantly impact on the experience of critical illness, notwithstanding the challenge of meeting families' needs for many clinicians in the intensive care unit (ICU). Family needs have been extensively researched; however, a previous Joanna Briggs Institute (JBI) systematic review was the first published systematic review recommending effective interventions for addressing family needs of critically ill patients in an acute intensive care setting...
March 2016: JBI Database of Systematic Reviews and Implementation Reports
Annemiek E Wolters, Linda M Peelen, Maartje C Welling, Lotte Kok, Dylan W de Lange, Olaf L Cremer, Diederik van Dijk, Arjen J C Slooter, Dieuwke S Veldhuijzen
OBJECTIVES: To determine whether delirium during ICU stay is associated with long-term mental health problems defined as symptoms of anxiety, depression, and posttraumatic stress disorder. DESIGN: Prospective cohort study. SETTING: Survey study, 1 year after discharge from a medical-surgical ICU in the Netherlands. PATIENTS: One-year ICU survivors of an ICU admission lasting more than 48 hours, without a neurologic disorder or other condition that would impede delirium assessment during ICU stay...
October 2016: Critical Care Medicine
Kelly M Shaffer, Eric Riklin, Jamie M Jacobs, Jonathan Rosand, Ana-Maria Vranceanu
OBJECTIVE: To assess the correlation of psychosocial resiliency factors (mindfulness and coping) with symptoms of posttraumatic stress, anxiety, and depression in patients recently admitted to the neuroscience ICU and their primary informal caregivers. DESIGN: A descriptive, cross-sectional correlational study. SETTING: Neuroscience ICU in a major medical center. PARTICIPANTS: A total of 78 dyads of patients (total n = 81) and their primary caregivers (total n = 92) from June to December 2015...
November 2016: Critical Care Medicine
Matilda Bäckberg, Jenny Westerbergh, Olof Beck, Anders Helander
BACKGROUND: New psychoactive substances (NPS) are often poorly pharmacologically documented and the production is unregulated, implying high risks for toxic side effects. This report from the STRIDA project describes analytically confirmed non-fatal intoxications involving the phenmetrazine analogue 3-fluorophenmetrazine (3-FPM). STUDY DESIGN AND METHODS: Observational case series of patients with suspected acute NPS exposure requiring hospital care. Blood and urine samples were collected from patients presenting in emergency departments (ED) or intensive care units (ICU), after consultation with the Swedish Poisons Information Centre (PIC)...
November 2016: Clinical Toxicology
Miyuki H Komachi, Kiyoko Kamibeppu
BACKGROUND: Families of cancer patients in the ICU often experience severe stress. Understanding their experience is important for providing family-centered care during this difficult period. Little is known about the experience of families of cancer patients admitted to the ICU. This study evaluated the prevalence of posttraumatic stress symptoms (PTSS) among families of cancer patients admitted to the ICU. METHODS: We carried out a longitudinal study at a teaching and advanced treatment hospital...
2016: Journal of Intensive Care
Shannon S Carson, Christopher E Cox, Sylvan Wallenstein, Laura C Hanson, Marion Danis, James A Tulsky, Emily Chai, Judith E Nelson
IMPORTANCE: Family caregivers of patients with chronic critical illness experience significant psychological distress. OBJECTIVE: To determine whether family informational and emotional support meetings led by palliative care clinicians improve family anxiety and depression. DESIGN, SETTING, AND PARTICIPANTS: A multicenter randomized clinical trial conducted from October 2010 through November 2014 in 4 medical intensive care units (ICUs). Adult patients (aged ≥21 years) requiring 7 days of mechanical ventilation were randomized and their family surrogate decision makers were enrolled in the study...
July 5, 2016: JAMA: the Journal of the American Medical Association
Linda L Chlan
Caring for critically ill patients receiving mechanical ventilation in the intensive care unit (ICU) is an immense challenge for clinicians. Interventions to maintain physiological stability and life itself can cause a number of adverse effects that have a marked impact on patients beyond the period of critical illness or injury. These ICU-acquired conditions include but are not limited to weakness, depression, and post-intensive care syndrome, all of which markedly affect patients' quality of life after they leave the unit...
July 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Veronica Ka Wai Lai, Anna Lee, Patricia Leung, Chun Hung Chiu, Ka Man Ho, Charles David Gomersall, Malcolm John Underwood, Gavin Matthew Joynt
INTRODUCTION: Patients and their families are understandably anxious about the risk of complications and unfamiliar experiences following cardiac surgery. Providing information about postoperative care in the intensive care unit (ICU) to patients and families may lead to lower anxiety levels, and increased satisfaction with healthcare. The objectives of this study are to evaluate the effectiveness of preoperative patient education provided for patients undergoing elective cardiac surgery...
2016: BMJ Open
Michael H Smolensky, Ramon C Hermida, Alain Reinberg, Linda Sackett-Lundeen, Francesco Portaluppi
Biological processes are organized in time as innate rhythms defined by the period (τ), phase (peak [Φ] and trough time), amplitude (A, peak-trough difference) and mean level. The human time structure in its entirety is comprised of ultradian (τ < 20 h), circadian (20 h > τ < 28 h) and infradian (τ > 28 h) bioperiodicities. The circadian time structure (CTS) of human beings, which is more complicated than in lower animals, is orchestrated and staged by a brain central multioscillator system that includes a prominent pacemaker - the suprachiasmatic nuclei of the hypothalamus...
2016: Chronobiology International
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