Click to Return to Search Page VIEW SELECTED LIBRARY MEDIA Name of Media: Research into mysterious ‘Long COVID’ symptoms picking up steam Author(s): Lawrence Specker Publisher or Source: al.com Type of Media: Newspaper Article Media Originally for: General Public Country of Origin: United States of America (the) Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: Yes Description: The long-term effects of COVID-19 continue to be a murky subject full of unsettling concerns such as lasting heart and nerve damage, but the effort to understand them is gaining strength and urgency. In the past week the Centers for Disease Control updated its public guidance on what’s sometimes known as “Long COVID,” with sufferers known as “long haulers.” On Sunday, the United Kingdom’s National Health Service announced that it was organizing a network of more than 40 specialist clinics to help sufferers and launching a task force whose mission is to produce a better understanding of just what Long COVID is. To view the PDF, Article, Photo, or Chart, Click Icon: To view the attached Video media file, Click Icon: PostICU, Inc's library staff reviewed this copyrighted material contained in the library and reasonably believes that its inclusion in our library complies with the "Fair Use Doctrine" because: (1) our library's is for nonprofit and educational purposes; (2) the nature of the copyrighted work is related to our mission; (3) the amount and substantiality of the portion used in relation to the copyrighted work as a whole is fair and reasonable; and (4) the potential market for or value of the copyrighted work will if impacted, should be enhanced, by its presence in our library.

Click to Return to Search Page VIEW SELECTED LIBRARY MEDIA Name of Media: Surviving a COVID-19 ICU stay is just the start. We're ignoring what else it takes to recover. Author(s): Kushal T. Kadakia Publisher or Source: NBCNews.com Type of Media: Newspaper Article Media Originally for: General Public Country of Origin: United States of America (the) Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: Yes Description: After the ICU, coronavirus patients need rehab facilities and staff to get them back to normal functioning, if they even can — the U.S. is short on both. To view the PDF, Article, Photo, or Chart, Click Icon: To view the attached Video media file, Click Icon: PostICU, Inc's library staff reviewed this copyrighted material contained in the library and reasonably believes that its inclusion in our library complies with the "Fair Use Doctrine" because: (1) our library's is for nonprofit and educational purposes; (2) the nature of the copyrighted work is related to our mission; (3) the amount and substantiality of the portion used in relation to the copyrighted work as a whole is fair and reasonable; and (4) the potential market for or value of the copyrighted work will if impacted, should be enhanced, by its presence in our library.

Click to Return to Search Page VIEW SELECTED LIBRARY MEDIA Name of Media: BIS monitoring versus clinical assessment for sedation in mechanically ventilated adults in the intensive care unit and its impact on clinical outcomes and resource utilization Author(s): Rajesh M Shetty, Antonio Bellini, Dhuleep S Wijayatilake, Mark A Hamilton, Rajesh Jain, Sunil Karanth, ArunKumar Namachivayam Publisher or Source: Cochrane Database of Systematic Reviews Type of Media: Medical Journal Media Originally for: Critical Care Physicians Country of Origin: India Primary Focus of Media: Pre-Use of PICS Designation COVID-19 Related: No Description: 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. Bispectral index (BIS) monitors, which are based on the processing of electroencephalographic signals, may overcome the restraints of the sedation scales and provide a more reliable and consistent guidance for the titration of sedation depth. The benefits of BIS monitoring of patients under general anaesthesia for surgical procedures have already been confirmed by another Cochrane review. By undertaking a well‐conducted systematic review our aim was to find out if BIS monitoring improves outcomes in mechanically ventilated adult intensive care unit (ICU) patients. Objectives To assess the effects of BIS monitoring compared with clinical sedation assessment on ICU length of stay (LOS), duration of mechanical ventilation, any cause mortality, risk of ventilator‐associated pneumonia (VAP), risk of adverse events (e.g. self‐extubation, unplanned disconnection of indwelling catheters), hospital LOS, amount of sedative agents used, cost, longer‐term functional outcomes and quality of life as reported by authors for mechanically ventilated adults in the ICU. Search methods We searched CENTRAL, MEDLINE, Embase, CINAHL, ProQuest, OpenGrey and SciSearch up to May 2017 and checked references citation searching and contacted study authors to identify additional studies. We searched trial registries, which included clinicaltrials.gov and controlled‐trials.com. Selection criteria We included all randomized controlled trials comparing BIS versus clinical assessment (CA) for the management of sedation in mechanically ventilated critically ill adults. Data collection and analysis We used Cochrane's standard methodological procedures. We undertook analysis using Revman 5.3 software. Main results We identified 4245 possible studies from the initial search. Of those studies, four studies (256 participants) met the inclusion criteria. One more study is awaiting classification. Studies were, conducted in single‐centre surgical and mixed medical‐surgical ICUs. BIS monitor was used to assess the level of sedation in the intervention arm in all the studies. In the control arm, the sedation assessment tools for CA included the Sedation‐Agitation Scale (SAS), Ramsay Sedation Scale (RSS) or subjective CA utilizing traditional clinical signs (heart rate, blood pressure, conscious level and pupillary size). Only one study was classified as low risk of bias, the other three studies were classified as high risk. There was no evidence of a difference in one study (N = 50) that measured ICU LOS (Median (Interquartile Range IQR) 8 (4 to 14) in the CA group; 12 (6 to 18) in the BIS group; low‐quality evidence).There was little or no effect on the duration of mechanical ventilation (MD ‐0.02 days (95% CI ‐0.13 to 0.09; 2 studies; N = 155; I2 = 0%; low‐quality evidence)). Adverse events were reported in one study (N = 105) and the effects on restlessness after suction, endotracheal tube resistance, pain tolerance during sedation or delirium after extubation were uncertain due to very low‐quality evidence. Clinically relevant adverse events such as self‐extubation were not reported in any study. Three studies reported the amount of sedative agents used. We could not measure combined difference in the amount of sedative agents used because of different sedation protocols and sedative agents used in the studies. GRADE quality of evidence was very low. No study reported other secondary outcomes of interest for the review. Authors' conclusions We found insufficient evidence about the effects of BIS monitoring for sedation in critically ill mechanically ventilated adults on clinical outcomes or resource utilization. The findings are uncertain due to the low‐ and very low‐quality evidence derived from a limited number of studies. To view the PDF, Article, Photo, or Chart, Click Icon: To view the attached Video media file, Click Icon: PostICU, Inc's library staff reviewed this copyrighted material contained in the library and reasonably believes that its inclusion in our library complies with the "Fair Use Doctrine" because: (1) our library's is for nonprofit and educational purposes; (2) the nature of the copyrighted work is related to our mission; (3) the amount and substantiality of the portion used in relation to the copyrighted work as a whole is fair and reasonable; and (4) the potential market for or value of the copyrighted work will if impacted, should be enhanced, by its presence in our library.

Click to Return to Search Page VIEW SELECTED LIBRARY MEDIA Name of Media: Long COVID Symptoms Are Common—Even After Mild or Asymptomatic Cases, New Study Shows Author(s): Carolyn L. Todd Publisher or Source: Self Type of Media: Newspaper Article Media Originally for: General Public,General Medical Professionals Country of Origin: United States of America (the) Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: Yes Description: Scientists are working to understand the array of lingering symptoms or new health conditions that may start weeks after a COVID-19 infection (sometimes termed long COVID, long-haul COVID, or post-acute COVID-19 syndrome). A huge new study published this week adds to a growing pile of research indicating that it is surprisingly common for people to experience new health problems after a COVID-19 infection. And the results suggest this can happen even among those who had mild-to-moderate or no symptoms during their illness. To view the PDF, Article, Photo, or Chart, Click Icon: To view the attached Video media file, Click Icon: PostICU, Inc's library staff reviewed this copyrighted material contained in the library and reasonably believes that its inclusion in our library complies with the "Fair Use Doctrine" because: (1) our library's is for nonprofit and educational purposes; (2) the nature of the copyrighted work is related to our mission; (3) the amount and substantiality of the portion used in relation to the copyrighted work as a whole is fair and reasonable; and (4) the potential market for or value of the copyrighted work will if impacted, should be enhanced, by its presence in our library.

Click to Return to Search Page VIEW SELECTED LIBRARY MEDIA Name of Media: Effectiveness of dexmedetomidine versus propofol on extubation times, length of stay and mortality rates in adult cardiac surgery patients: a systematic review and meta-analysis Author(s): John Nguyen , and Noel Nacpil Publisher or Source: Joanna Briggs Institute Type of Media: Medical Journal Media Originally for: Critical Care Physicians Country of Origin: United Kingdom of Great Britain and Northern Ireland (the) Primary Focus of Media: Pre-Use of PICS Designation COVID-19 Related: No Description: Objective: To determine the effects of dexmedetomidine versus propofol on extubation time, intensive care unit (ICU) length of stay, total hospital length of stay and in-hospital mortality rates in cardiac surgery patients. To view the PDF, Article, Photo, or Chart, Click Icon: To view the attached Video media file, Click Icon: PostICU, Inc's library staff reviewed this copyrighted material contained in the library and reasonably believes that its inclusion in our library complies with the "Fair Use Doctrine" because: (1) our library's is for nonprofit and educational purposes; (2) the nature of the copyrighted work is related to our mission; (3) the amount and substantiality of the portion used in relation to the copyrighted work as a whole is fair and reasonable; and (4) the potential market for or value of the copyrighted work will if impacted, should be enhanced, by its presence in our library.

Click to Return to Search Page VIEW SELECTED LIBRARY MEDIA Name of Media: MONITOR-IC study, a mixed methods prospective multi-centre-controlled cohort study assessing 5-year outcomes of ICU survivors and related healthcare costs: a study protocol Author(s): Wytske Geense, Marieke Zegers, Hester Vermeulen, Mark van den Boogaard, Johannes van der Hoeven Publisher or Source: BMJ Type of Media: Medical Journal Media Originally for: Critical Care Physicians,General Medical Professionals,Nurses and/or Other Critical Care Medical Professionals Country of Origin: Netherlands (the) Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: No Description: 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. Methods The MONITOR-IC study is a multicentre prospective controlled cohort study, carried out in ICUs in four Dutch hospitals. Patients will be included between July 2016 and July 2021 and followed for 5 years. We estimated to include 12000 ICU patients. Outcomes are the HRQoL, physical, cognitive and mental symptoms, ICU survivors’ care and support needs, healthcare use and related costs. A control cohort of otherwise seriously ill patients will be assembled to compare long-term patient-reported outcomes. We will use a mixed methods design, including questionnaires, medical data from patient records, cost data from health insurance companies and interviews with patients and family members. Ethics and dissemination Insights from this study will be used to inform ICU patients and their family members about long-term consequences of ICU care, and to develop prediction and screening instruments to detect patients at risk for PICS. Subsequently, tailored interventions can be developed and implemented to prevent and mitigate long-term consequences. Additionally, insights into the ratio between HRQoL of ICU patients and related healthcare costs during 5 years after ICU admission can be used to discuss the added value of ICU care from a community perspective. The study has been approved by the research ethics committee of the Radboud University Medical Center (2016-2724).clinical trial registration NCT03246334 To view the PDF, Article, Photo, or Chart, Click Icon: To view the attached Video media file, Click Icon: PostICU, Inc's library staff reviewed this copyrighted material contained in the library and reasonably believes that its inclusion in our library complies with the "Fair Use Doctrine" because: (1) our library's is for nonprofit and educational purposes; (2) the nature of the copyrighted work is related to our mission; (3) the amount and substantiality of the portion used in relation to the copyrighted work as a whole is fair and reasonable; and (4) the potential market for or value of the copyrighted work will if impacted, should be enhanced, by its presence in our library.

Click to Return to Search Page VIEW SELECTED LIBRARY MEDIA Name of Media: Post-Intensive Care Syndrome (PICS): Strategies to meet the needs of the patient during & after critical illness Author(s): Boehm, L., Hoskins, A. Publisher or Source: Vanderbilt University Medical Center Type of Media: PowerPoint Media Originally for: General Public, General Medical Professionals Country of Origin: United States Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: No Description: Define the characteristics of Post-Intensive Care Syndrome (PICS). Identify the incidence, prevalence and risk factors of PICS. Identify strategies for preventing and managing PICS. To view the PDF, Article, Photo, or Chart, Click Icon: To view the attached Video media file, Click Icon: PostICU, Inc's library staff reviewed this copyrighted material contained in the library and reasonably believes that its inclusion in our library complies with the "Fair Use Doctrine" because: (1) our library's is for nonprofit and educational purposes; (2) the nature of the copyrighted work is related to our mission; (3) the amount and substantiality of the portion used in relation to the copyrighted work as a whole is fair and reasonable; and (4) the potential market for or value of the copyrighted work will if impacted, should be enhanced, by its presence in our library.

Click to Return to Search Page VIEW SELECTED LIBRARY MEDIA Name of Media: Covid-19 Resources: Post ICU Syndrome Author(s): Keith Killu, MD, FCCM; Varsha P. Gharpure, MD; Kristie A. Hertel, ACNP, CCRN, MSM, FCCM; Heatherlee Bailey, MD, FAAEM, FCCM Publisher or Source: Society of critical care medicine Type of Media: Video Media Originally for: Critical Care Physicians,Former ICU Patients,Former ICU Patients' Family Members, Friends or Caregivers,General Medical Professionals,Nurses and/or Other Critical Care Medical Professionals Country of Origin: United States of America (the) Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: Yes Description: Expert speakers discussed about post-icu syndrome found in Covid-19 patients. To view the PDF, Article, Photo, or Chart, Click Icon: To view the attached Video media file, Click Icon: PostICU, Inc's library staff reviewed this copyrighted material contained in the library and reasonably believes that its inclusion in our library complies with the "Fair Use Doctrine" because: (1) our library's is for nonprofit and educational purposes; (2) the nature of the copyrighted work is related to our mission; (3) the amount and substantiality of the portion used in relation to the copyrighted work as a whole is fair and reasonable; and (4) the potential market for or value of the copyrighted work will if impacted, should be enhanced, by its presence in our library.

Click to Return to Search Page VIEW SELECTED LIBRARY MEDIA Name of Media: Critically Ill COVID-19 Patients Are at High Risk of Post–Intensive Care Syndrome Author(s): Massachusetts General Hospital Publisher or Source: Massachusetts General Hospital Type of Media: One-Pager Media Originally for: Critical Care Physicians,General Public,General Medical Professionals,Nurses and/or Other Critical Care Medical Professionals Country of Origin: United States of America (the) Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: Yes Description: Most survivors of respiratory failure develop post-intensive care syndrome (PICS). PICS can persist for months to years and may severely impair quality of life. In a fast literature update posted on May 20, 2020, Anica Law, MD, a clinician at Beth Israel Deaconess Medical Center and former fellow in the Division of Pulmonary and Critical Care Medicine at Massachusetts General Hospital, describes PICS and the measures that potentially improve outcomes of COVID-19 patients who survive an ICU stay. To view the PDF, Article, Photo, or Chart, Click Icon: To view the attached Video media file, Click Icon: PostICU, Inc's library staff reviewed this copyrighted material contained in the library and reasonably believes that its inclusion in our library complies with the "Fair Use Doctrine" because: (1) our library's is for nonprofit and educational purposes; (2) the nature of the copyrighted work is related to our mission; (3) the amount and substantiality of the portion used in relation to the copyrighted work as a whole is fair and reasonable; and (4) the potential market for or value of the copyrighted work will if impacted, should be enhanced, by its presence in our library.

Click to Return to Search Page VIEW SELECTED LIBRARY MEDIA Name of Media: Risk factors for mortality and mortality rates in interstitial lung disease patients in the intensive care unit Author(s): Huapaya, J. A., Wilfong, E. M., Harden, C. T., Brower, R. G., & Danoff, S. K. Publisher or Source: European respiratory review : an official journal of the European Respiratory Society Type of Media: Medical Journal Media Originally for: Critical Care Physicians Country of Origin: United States of America (the) Primary Focus of Media: Pre-Use of PICS Designation COVID-19 Related: No Description: Data on interstitial lung disease (ILD) outcomes in the intensive care unit (ICU) is of limited value due to population heterogeneity. The aim of this study was to examine risk factors for mortality and ILD mortality rates in the ICU.We performed a systematic review using five databases. 50 studies were identified and 34 were included: 17 studies on various aetiologies of ILD (mixed-ILD) and 17 on idiopathic pulmonary fibrosis (IPF). In mixed-ILD, elevated APACHE score, hypoxaemia and mechanical ventilation are risk factors for mortality. No increased mortality was found with steroid use. Evidence is inconclusive on advanced age. In IPF, evidence is inconclusive for all factors except mechanical ventilation and hypoxaemia. The overall in-hospital mortality was available in 15 studies on mixed-ILD (62% in 2001-2009 and 48% in 2010-2017) and 15 studies on IPF (79% in 1993-2004 and 65% in 2005-2017). Follow-up mortality rate at 1 year ranged between 53% and 100%.Irrespective of ILD aetiology, mechanical ventilation is associated with increased mortality. For mixed-ILD, hypoxaemia and APACHE scores are also associated with increased mortality. IPF has the highest mortality rate among ILDs, but since 1993 the rate appears to be declining. Despite improving in-hospital survival, overall mortality remains high. To view the PDF, Article, Photo, or Chart, Click Icon: To view the attached Video media file, Click Icon: PostICU, Inc's library staff reviewed this copyrighted material contained in the library and reasonably believes that its inclusion in our library complies with the "Fair Use Doctrine" because: (1) our library's is for nonprofit and educational purposes; (2) the nature of the copyrighted work is related to our mission; (3) the amount and substantiality of the portion used in relation to the copyrighted work as a whole is fair and reasonable; and (4) the potential market for or value of the copyrighted work will if impacted, should be enhanced, by its presence in our library.

Click to Return to Search Page VIEW SELECTED LIBRARY MEDIA Name of Media: Incorporating Dynamic Assessment of Fluid Responsiveness Into Goal-Directed Therapy: A Systematic Review and Meta-Analysis Author(s): Joseph M. Bednarczyk, MD, FRCPC; Jason A. Fridfinnson, MD; Anand Kumar, MD, FRCPC; Laurie Blanchard, MLIS; Rasheda Rabbani, PhD; Dean Bell, MD, FRCPC; Duane Funk, MD, FRCPC; Alexis F. Turgeon, MD, MSc, FRCPC; Ahmed M. Abou-Setta, MD, PhD; Ryan Zarychanski, MD, MSc, FRCPC Publisher or Source: Critical Care Medicine Type of Media: Medical Journal Media Originally for: Critical Care Physicians Country of Origin: Canada Primary Focus of Media: Pre-Use of PICS Designation COVID-19 Related: No Description: Objective: Dynamic tests of fluid responsiveness have been developed and investigated in clinical trials of goal-directed therapy. The impact of this approach on clinically relevant outcomes is unknown. We performed a systematic review and meta-analysis to evaluate whether fluid therapy guided by dynamic assessment of fluid responsiveness compared with standard care improves clinically relevant outcomes in adults admitted to the ICU. Data sources: Randomized controlled trials from MEDLINE, EMBASE, CENTRAL, clinicaltrials.gov, and the International Clinical Trials Registry Platform from inception to December 2016, conference proceedings, and reference lists of relevant articles. Study selection: Two reviewers independently identified randomized controlled trials comparing dynamic assessment of fluid responsiveness with standard care for acute volume resuscitation in adults admitted to the ICU. Data extraction: Two reviewers independently abstracted trial-level data including population characteristics, interventions, clinical outcomes, and source of funding. Our primary outcome was mortality at longest duration of follow-up. Our secondary outcomes were ICU and hospital length of stay, duration of mechanical ventilation, and frequency of renal complications. The internal validity of trials was assessed in duplicate using the Cochrane Collaboration's Risk of Bias tool. Data synthesis: We included 13 trials enrolling 1,652 patients. Methods used to assess fluid responsiveness included stroke volume variation (nine trials), pulse pressure variation (one trial), and stroke volume change with passive leg raise/fluid challenge (three trials). In 12 trials reporting mortality, the risk ratio for death associated with dynamic assessment of fluid responsiveness was 0.59 (95% CI, 0.42-0.83; I = 0%; n = 1,586). The absolute risk reduction in mortality associated with dynamic assessment of fluid responsiveness was -2.9% (95% CI, -5.6% to -0.2%). Dynamic assessment of fluid responsiveness was associated with reduced duration of ICU length of stay (weighted mean difference, -1.16 d [95% CI, -1.97 to -0.36]; I = 74%; n = 394, six trials) and mechanical ventilation (weighted mean difference, -2.98 hr [95% CI, -5.08 to -0.89]; I = 34%; n = 334, five trials). Three trials were adjudicated at unclear risk of bias; the remaining trials were at high risk of bias. Conclusions: In adult patients admitted to intensive care who required acute volume resuscitation, goal-directed therapy guided by assessment of fluid responsiveness appears to be associated with reduced mortality, ICU length of stay, and duration of mechanical ventilation. High-quality clinical trials in both medical and surgical ICU populations are warranted to inform routine care. To view the PDF, Article, Photo, or Chart, Click Icon: To view the attached Video media file, Click Icon: PostICU, Inc's library staff reviewed this copyrighted material contained in the library and reasonably believes that its inclusion in our library complies with the "Fair Use Doctrine" because: (1) our library's is for nonprofit and educational purposes; (2) the nature of the copyrighted work is related to our mission; (3) the amount and substantiality of the portion used in relation to the copyrighted work as a whole is fair and reasonable; and (4) the potential market for or value of the copyrighted work will if impacted, should be enhanced, by its presence in our library.

Click to Return to Search Page VIEW SELECTED LIBRARY MEDIA Name of Media: VA ICU treatment improves patient outcomes Author(s): u.s department of veteran affairs Publisher or Source: VAntage Point Blog Type of Media: Newspaper Article Media Originally for: General Public Country of Origin: United States of America (the) Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: No Description: When Navy Veteran Ralph Gervasio Jr. was admitted in the intensive care unit (ICU) at Nashville VA Medical Center in 2017 for acute respiratory failure, he didn’t know that his road to recovery would be one of the most difficult times in his life. Well into his 60s, the Vietnam War Veteran had maintained a life-long strength and fitness regimen. But after three weeks in the Intensive Care Unit (ICU), Gervasio faced the effects of Post-Intensive Care Syndrome (PICS). “I can attest to the physical aspect of PICS. I had lost nearly 30 pounds and much of my muscle mass. As a result, I couldn’t curl a 30-pound weight even once.” Like Gervasio, many critically ill patients experience stressful situations that may cause them to develop problems related to their time in the ICU. It’s a struggle that Kelly Drumright, a clinical nurse leader at the Nashville VA Medical Center, is working to fix. To view the PDF, Article, Photo, or Chart, Click Icon: To view the attached Video media file, Click Icon: PostICU, Inc's library staff reviewed this copyrighted material contained in the library and reasonably believes that its inclusion in our library complies with the "Fair Use Doctrine" because: (1) our library's is for nonprofit and educational purposes; (2) the nature of the copyrighted work is related to our mission; (3) the amount and substantiality of the portion used in relation to the copyrighted work as a whole is fair and reasonable; and (4) the potential market for or value of the copyrighted work will if impacted, should be enhanced, by its presence in our library.