Click to Return to Search Page VIEW SELECTED LIBRARY MEDIA Name of Media: SIGN157: Risk reduction and management of delirium Author(s): Euan Bremner, Karen Graham, Aimie Little, Domenico Romano, Gaynor Rattray, Carolyn Sleit, Karen Martin, James McKillop, and Rachael Wybrew Publisher or Source: NHS Scotland Type of Media: Medical Professional Education Media Originally for: Critical Care Physicians, General Medical Professionals, Nurses and/or Other Critical Care Medical Professionals Country of Origin: United Kingdom Primary Focus of Media: Pre-Use of PICS Designation COVID-19 Related: No Description: Delirium is an acute deterioration in mental functioning arising over hours or days that is triggered mainly by acute medical illness, surgery, trauma, or drugs. It was previously termed ‘acute confusional state’. Delirium is independently linked with poor outcomes including medical complications, falls, increased length of hospital stay, new institutionalisation, and mortality.It can cause significant patient and carer distress. The main features of delirium are acute cognitive deficits and altered level of arousal, with up to half of patients also experiencing hallucinations or delusions. Delirium varies in duration, mostly resolving within days, but in some people it can last weeks or months. Delirium is among the most common of medical emergencies. A UK study found a prevalence of 20% in adult acute general medical patients. The prevalence is higher in particular clinical groups, such as patients in intensive care units (ICU). It affects up to 50% who have hip fracture and up to 75% in intensive care. Several predisposing factors increase the risk of delirium, including older age, dementia, frailty, the presence of multiple comorbidities, male sex, sensory impairments, a history of depression, a history of delirium, and alcohol misuse. Despite its importance, there are deficiencies in care of people with delirium in Scotland. It is underdiagnosed, and the treatment of patients with established delirium is variable. Preventative measures can reduce the incidence of delirium, yet few clinical units have formal delirium risk-reduction programmes. Experience gained from quality improvement programmes in Scotland shows that advances can be made. There is potential to improve clinical practice by reducing variation in the standards of assessment and management of people with delirium. This new national guideline on delirium provides a critical focal point for Scotland-wide improvements in delirium care. Because delirium is so common, all healthcare staff having contact with acutely unwell patients need to assume responsibility for detecting and treating it, as well as aiming to reduce the risk of delirium occurring. Those working in the long-term care environment should be able to recognise delirium, reduce risk, and monitor those in their care to resolve delirium. 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: Implementing a Mobility Program to Minimize Post–Intensive Care Syndrome Author(s): Hopkins, R. O., Mitchell, L., Thomsen, G. E., Schafer, M., Link, M., Brown, S. M. Publisher or Source: American Association of Critical Care Nurses Type of Media: Medical Journal Media Originally for: General Medical Professionals Country of Origin: United States Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: No Description: Immobility in the intensive care unit (ICU) is associated with neuromuscular weakness, post–intensive care syndrome, functional limitations, and high costs. Early mobility–based rehabilitation in the ICU is feasible and safe. Mobility-based rehabilitation varied widely across 5 ICUs in 1 health care system, suggesting a need for continuous training and evaluation to maintain a strong mobility-based rehabilitation program. Early mobility–based rehabilitation shortens ICU and hospital stays, reduces delirium, and increases muscle strength and the ability to ambulate. Long-term effects include increased ability for self-care, faster return to independent functioning, improved physical function, and reduced hospital readmission and death. Factors that influence early mobility–based rehabilitation include having an interdisciplinary team; strong unit leadership; access to physical, occupational, and respiratory therapists; a culture focused on patient safety and quality improvement; a champion of early mobility; and a focus on measuring performance and outcomes. 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 of Post-traumatic Stress Symptoms in Family Members of Intensive Care Unit Patients Author(s): Elie Azoulay , Frédéric Pochard , Nancy Kentish-Barnes , Sylvie Chevret , Jérôme Aboab , Christophe Adrie , Djilali Annane , Gérard Bleichner , Pierre Edouard Bollaert , Michael Darmon , Thomas Fassier , Richard Galliot , Maité Garrouste-Orgeas , Cyril Goulenok , Dany Goldgran-Toledano , Jan Hayon , Mercé Jourdain , Michel Kaidomar , Christian Laplace , Jérôme Larché , Jérôme Liotier , Laurent Papazian , Catherine Poisson , Jean Reignier , Fayçal Saidi , and Benoît Schlemmer Publisher or Source: American Journal of Respiratory and Critical Care Medicine Type of Media: Medical Journal Media Originally for: Critical Care Physicians Country of Origin: France Primary Focus of Media: Post Traumatic Stress Disorder (PTSD) COVID-19 Related: No Description: Rationale: Intensive care unit (ICU) admission of a relative is a stressful event that may cause symptoms of post-traumatic stress disorder (PTSD). Objectives: Factors associated with these symptoms need to be identified. Methods: For patients admitted to 21 ICUs between March and November 2003, we studied the family member with the main potential decision-making role. Measurements: Ninety days after ICU discharge or death, family members completed the Impact of Event Scale (which evaluates the severity of post-traumatic stress reactions), Hospital Anxiety and Depression Scale, and 36-item Short-Form General Health Survey during a telephone interview. Linear regression was used to identify factors associated with the risk of post-traumatic stress symptoms. Main results: Interviews were obtained for family members of 284 (62%) of the 459 eligible patients. Post-traumatic stress symptoms consistent with a moderate to major risk of PTSD were found in 94 (33.1%) family members. Higher rates were noted among family members who felt information was incomplete in the ICU (48.4%), who shared in decision making (47.8%), whose relative died in the ICU (50%), whose relative died after end-of-life decisions (60%), and who shared in end-of-life decisions (81.8%). Severe post-traumatic stress reaction was associated with increased rates of anxiety and depression and decreased quality of life. Conclusion: Post-traumatic stress reaction consistent with a high risk of PTSD is common in family members of ICU patients and is the rule among those who share in end-of-life decisions. Research is needed to investigate PTSD rates and to devise preventive and early-detection strategies. 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: Scientists discover cause of COVID-19 long-hauler symptoms Author(s): Dr. Mary Gillis, D.Ed. Publisher or Source: wishtv.com 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: NDIANAPOLIS (WISH) — Why a person would still present symptoms of the coronavirus after they’ve cleared the infection has remained a mystery to doctors for more than a year. Now, they may have an answer. In a new paper published in the latest issue of Pathogens, scientists say it has to do with the reactivation of another viral infection: the Epstein-Barr virus. 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: ICU survivors at higher risk of suicide Author(s): Colin Perkel Publisher or Source: The Canadian Press Type of Media: Newspaper Article Media Originally for: Critical Care Physicians,General Public,General Medical Professionals,Nurses and/or Other Critical Care Medical Professionals Country of Origin: Canada Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: Yes Description: TORONTO — Patients discharged from intensive care are at higher risk of suicide, according to new research, suggesting that people who survive a serious COVID-19 infection could also be more likely to harm themselves. 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: Is your loved one confused? This could be a common condition called Delirium Author(s): Kendall Gross, PharmaD; and Ashley Thompson, PharmD Publisher or Source: University of California, San Francisco Type of Media: Brochure Media Originally for: Former ICU Patients' Family Members, Friends or Caregivers Country of Origin: United States Primary Focus of Media: Pre-Use of PICS Designation COVID-19 Related: No Description: The brochure describes the symptoms of people with Delirium, and what the family can do to help. 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: New support group for Post Intensive Care Syndrome Author(s): Robin Caudell Publisher or Source: Press-Republican Type of Media: Newspaper Article Media Originally for: Former ICU Patients or Their Caregivers Country of Origin: United States Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: No Description: PLATTSBURGH — There is a gap in care when people leave the ICU and return to their lives. To help those suffering after an ICU admission, a Post Intensive Care Syndrome (PICS) Support Group was launched at the University of Vermont Health Network, Champlain Valley Physicians Hospital in Plattsburgh. 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: Clinical review: intensive care unit acquired weakness Author(s): Hermans, G., Van den Berghe, G Publisher or Source: Critical Care Type of Media: Medical Journal Media Originally for: Critical Care Physicians Country of Origin: United Kingdom Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: No Description: A substantial number of patients admitted to the ICU because of an acute illness, complicated surgery, severe trauma, or burn injury will develop a de novo form of muscle weakness during the ICU stay that is referred to as “intensive care unit acquired weakness” (ICUAW). This ICUAW evoked by critical illness can be due to axonal neuropathy, primary myopathy, or both. Underlying pathophysiological mechanisms comprise microvascular, electrical, metabolic, and bioenergetic alterations, interacting in a complex way and culminating in loss of muscle strength and/or muscle atrophy. ICUAW is typically symmetrical and affects predominantly proximal limb muscles and respiratory muscles, whereas facial and ocular muscles are often spared. The main risk factors for ICUAW include high severity of illness upon admission, sepsis, multiple organ failure, prolonged immobilization, and hyperglycemia, and also older patients have a higher risk. The role of corticosteroids and neuromuscular blocking agents remains unclear. ICUAW is diagnosed in awake and cooperative patients by bedside manual testing of muscle strength and the severity is scored by the Medical Research Council sum score. In cases of atypical clinical presentation or evolution, additional electrophysiological testing may be required for differential diagnosis. The cornerstones of prevention are aggressive treatment of sepsis, early mobilization, preventing hyperglycemia with insulin, and avoiding the use parenteral nutrition during the first week of critical illness. Weak patients clearly have worse acute outcomes and consume more healthcare resources. Recovery usually occurs within weeks or months, although it may be incomplete with weakness persisting up to 2 years after ICU discharge. Prognosis appears compromised when the cause of ICUAW involves critical illness polyneuropathy, whereas isolated critical illness myopathy may have a better prognosis. In addition, ICUAW has shown to contribute to the risk of 1-year mortality. Future research should focus on new preventive and/or therapeutic strategies for this detrimental complication of critical illness and on clarifying how ICUAW contributes to poor longer-term prognosis. 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: Early Mobility and Exercise Author(s): Society of Critical Care Medicine Publisher or Source: Society of Critical Care Medicine Type of Media: PowerPoint Media Originally for: Critical Care Physicians, General Medical Professionals, Nurses and/or Other Critical Care Medical Professionals Country of Origin: United States Primary Focus of Media: Pre-Use of PICS Designation COVID-19 Related: No Description: Objectives: 1. Understand the deficits ICU survivors face and describe the benefits of early mobility in ICU 2. Identify strategies for successful implementation of early mobilization programs in your ICU 3. Discuss potential barriers to early mobilization programs 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: Suicide and self-harm in adult survivors of critical illness: population based cohort study Author(s): Shannon M Fernando, Danial Qureshi, Manish M Sood, Michael Pugliese, Robert Talarico, Daniel T Myran, Margaret S Herridge, Dale M Needham, Bram Rochwerg, Deborah J Cook, Hannah Wunsch, Robert A Fowler,Damon C Scales, O Joseph Bienvenu, Kathryn M Rowan, Magdalena Kisilewicz, Laura H Thompson, Peter Tanuseputro, Kwadwo Kyeremanteng 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: Canada Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: Yes Description: Objective To analyse the association between survival from critical illness and suicide or self-harm after hospital discharge. Design Population based cohort study using linked and validated provincial databases. Setting Ontario, Canada between January 2009 and December 2017 (inclusive). Participants Consecutive adult intensive care unit (ICU) survivors (≥18 years) were included. Linked administrative databases were used to compare ICU hospital survivors with hospital survivors who never required ICU admission (non-ICU hospital survivors). Patients were categorised based on their index hospital admission (ICU or non-ICU) during the study period. Main outcome measures The primary outcome was the composite of death by suicide (as noted in provincial death records) and deliberate self-harm events after discharge. Each outcome was also assessed independently. Incidence of suicide was evaluated while accounting for competing risk of death from other causes. Analyses were conducted by using overlap propensity score weighted, cause specific Cox proportional hazard models. Results 423 060 consecutive ICU survivors (mean age 61.7 years, 39% women) were identified. During the study period, the crude incidence (per 100 000 person years) of suicide, self-harm, and the composite of suicide or self-harm among ICU survivors was 41.4, 327.9, and 361.0, respectively, compared with 16.8, 177.3, and 191.6 in non-ICU hospital survivors. Analysis using weighted models showed that ICU survivors (v non-ICU hospital survivors) had a higher risk of suicide (adjusted hazards ratio 1.22, 95% confidence interval 1.11 to 1.33) and self-harm (1.15, 1.12 to 1.19). Among ICU survivors, several factors were associated with suicide or self-harm: previous depression or anxiety (5.69, 5.38 to 6.02), previous post-traumatic stress disorder (1.87, 1.64 to 2.13), invasive mechanical ventilation (1.45, 1.38 to 1.54), and renal replacement therapy (1.35, 1.17 to 1.56). Conclusions Survivors of critical illness have increased risk of suicide and self-harm, and these outcomes were associated with pre-existing psychiatric illness and receipt of invasive life support. Knowledge of these prognostic factors might allow for earlier intervention to potentially reduce this important public health problem. 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: Telemetric adjustable pulmonary artery banding for pulmonary hypertension in infants with congenital heart defects Author(s): National Institute for Health and Care Excellence - NICE Publisher or Source: National Institute for Health and Care Excellence - NICE Type of Media: Medical Professional Education Media Originally for: Critical Care Physicians,Nurses and/or Other Critical Care Medical Professionals 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: The National Institute for Health and Care Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Telemetric adjustable pulmonary artery banding for reducing pulmonary hypertension in infants with congenital heart defects, in November 2014. January 2018: The device linked to this guidance (FloWatch) is no longer available. NICE would consider whether to issue new guidance on Telemetric adjustable pulmonary artery banding for pulmonary hypertension in infants with congenital heart defects should evidence using an appropriately CE marked device become available. Description Congenital heart defects with a left-to-right shunt and excessive pulmonary blood flow can result in pulmonary hypertension and congestive heart failure in the neonatal period. The usual treatment is surgical correction of any defect when the infant is big enough. The most common defects needing this type of treatment include functionally univentricular hearts, transposition of the great arteries and atrioventricular or multiple septal defects. The symptoms include fatigue, dyspnoea, tachypnoea and failure to thrive if the lungs are not protected. Infants may develop a condition of irreversible pulmonary hypertension because of hypertrophy of the pulmonary arterioles. Pulmonary artery banding (PAB) is a palliative procedure that is used as part of staged treatment before definitive surgical correction of congenital heart defects. The aim of PAB is to reduce the diameter of the main pulmonary artery, decreasing blood flow and reducing pulmonary artery pressure. Improvement of systemic pressure, cardiac output and ventricular function can also be expected in patients with a large left-to-right shunt. Risks of the procedure include lowering of systemic oxygen saturation, ventricular hypertrophy, subaortic obstruction, and pulmonary branch and valve distortion. The conventional technique of PAB involves surgical placement of a (not telemetrically adjustable) band around the main pulmonary artery. Different techniques using a variety of materials (such as strips of polytetrafluoroethylene, polydioxanone or nylon) and sutures are used. In non-adjustable PAB methods, reoperation is often needed to adjust the tightness of the band. 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: Here’s What Recovery From Covid-19 Looks Like for Many Survivors Author(s): Bam Belluck Publisher or Source: The New York Times 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: Hundreds of thousands of seriously ill coronavirus patients who survive and leave the hospital are facing a new and difficult challenge: recovery. Many are struggling to overcome a range of troubling residual symptoms, and some problems may persist for months, years or even the rest of their lives. 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.