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Patient and Family Post–Intensive Care Syndrome
Judy E. Davidson, RN, DNP; and Maurene A. Harvey, MPH
AACN Advanced Critical Care
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Critical Care Physicians, General Medical Professionals, Nurses and/or Other Critical Care Medical Professionals
For years it has been known that many patients who survive critical illness do not return to their original state of health, resulting in long-term consequences of critical illness. Weakness acquired in the intensive care unit (ICU) is a physical consequence occurring in 25% to 80% of patients who receive mechanical ventilation for more than 4 days and in 50% to 75% of patients with sepsis. Nearly all patients affected with ICU-acquired weakness have symptoms that persist years later. Issues with cognitive function occur in 30% to 80% of ICU survivors and include memory, planning, problem-solving, visual-spatial, and processing problems. Cognitive consequences may improve during the months after discharge. However, 25% of patients with adult respiratory distress syndrome (ARDS) have long-term persistent cognitive impairment 6 years after discharge. In several studies,1-3 survivors of severe sepsis who were more than 65 years of age still had cognitive impairment 8 years after hospital discharge. Anxiety, depression, and sleep disturbances can last from months to years. Survivors also experience post traumatic stress disorder (PTSD) long-term, with an incidence between 10% and 50% and persisting for up to 8 years. Follow-up studies longer than 8 years have not been reported, and for some survivors, these consequences of critical illness may not resolve.
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