Click to Return to Search Page VIEW SELECTED LIBRARY MEDIA Name of Media: Facing Post-Intensive Care Syndrome and After-Effects of Covid-19 Author(s): Nancy Maes Publisher or Source: Chicago Health Type of Media: Newspaper Article Media Originally for: General Public Country of Origin: United States Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: Yes Description: Of all his years, 2020 was exceptionally challenging for Vietnam veteran Matthew Thomas. After the 75-year-old Aurora resident tested positive for Covid-19 in mid-May, doctors had to intubate him for 33 days so he didn’t go into respiratory failure. While Thomas survived, his 33-year-old son, diagnosed with Covid-19 shortly before his father was hospitalized, passed away. Thomas also faced widespread effects from Covid-19, stemming from the time spent intubated and in intensive care. “The byproduct of the disease is that my muscles went to sleep,” says Thomas, who says his muscles became so weak that he could not use his arms and legs. “I couldn’t do anything. I couldn’t even stand up,” he says. 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: Traumatized by Hospital Stay: 1 in 3 Patients Develop PTSD from ICU Author(s): Ashik Siddique Publisher or Source: Medical Daily Type of Media: Newspaper Article Media Originally for: General Public Country of Origin: United States Primary Focus of Media: Post Traumatic Stress Disorder (PTSD) COVID-19 Related: No Description: Another reason to be wary of a hospital stay- a new study shows that patients who survive intensive care units in hospitals are at high risk for developing post-traumatic stress disorder (PTSD). PTSD is in the news most often in relation to combat veterans, but researchers from the Johns Hopkins University School of Medicine found that one in three people who survived an intensive care unit (ICU) stay for acute lung injury showed PTSD symptoms that lasted up to two years. 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: Assess, Prevent and Manage Pain 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: The objectives of the Power point are: • Compare valid & reliable pain assessment tools • Identify special challenges to effective pain assessment, prevention, & management • Integrate effective strategies to prevent & manage pain into everyday clinical practice • Incorporate evidence from the PAD Guidelines, including Quality of Evidence and Strength of Recommendations 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: Nightmares After the I.C.U. Author(s): Jan Hoffman Publisher or Source: The New York Times Type of Media: Newspaper Article Media Originally for: General Public Country of Origin: United States Primary Focus of Media: Post Traumatic Stress Disorder (PTSD) COVID-19 Related: No Description: Patients who have prolonged stays, getting intubated and sedated, may experience severe hallucinations, putting them at risk of PTSD for years to come, studies show. 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: Persistent Covid-19 manifests with symptoms of 4 different syndromes – News Author(s): AlKhaleej Today Publisher or Source: AlKhaleej Today Type of Media: Newspaper Article Media Originally for: General Public Country of Origin: United Arab Emirates (the) Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: Yes Description: Persistent covid-19, in which patients experience symptoms for months, may be affecting people in four different ways at once. And that may explain why patients with these persistent symptoms are not receiving adequate treatment. In addition, there may be a huge psychological impact on patients with this long covid-19, points out a review of studies by the United Kingdom’s National Institute for Health Research. These people need more support, and health professionals, more information. 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: Venous thromboembolism in COVID-19: systematic review of reported risks and current guidelines. Author(s): Fontana, P., Casini, A., Robert-Ebadi, H., Glauser, F., Righini, M., & Blondon, M. Publisher or Source: Swiss medical weekly Type of Media: Medical Journal Media Originally for: Critical Care Physicians,Nurses and/or Other Critical Care Medical Professionals Country of Origin: Switzerland Primary Focus of Media: Pre-Use of PICS Designation COVID-19 Related: Yes Description: Aims of the study: Many centres have noticed a high number of venous thromboembolism (VTE) events among critically ill inpatients with COVID-19 pneumonia. The aims of this study were (1) to summarise the reported risk of VTE associated with COVID-19 infections and (2) to summarise guidance documents on thromboprophylaxis in COVID-19 patients, in a systematic review. Methods: We systematically searched for peer-reviewed evidence on the risk of VTE in patients with COVID-19, in PubMed, Embase and Twitter, and for guidelines or guidance documents for thromboprophylaxis, from international or national societies relevant to the field of thrombosis and haemostasis, up to April 30 2020. Results: We found 11 studies (1 clinical trial, 7 retrospective cohorts and 3 prospective cohorts), which included a range of 16 to 388 in patients with COVID-19 (total of 1369 inpatients). The diagnoses of COVID-19 and VTE were of high quality, but the follow-up was often unclear. Most studies reported universal in-hospital thromboprophylaxis. Among all inpatients and among intensive care unit (ICU) inpatients with COVID-19, reported risks of VTE were 4.4–8.2% (three studies) and 0–35.3% (six studies), respectively. Two studies at least partially screened for VTE in ICU inpatients with COVID-19, and found risks of 24.7–53.8%. We found 12 guidelines for thromboprophylaxis of COVID-19 patients. The majority suggested universal pharmacological thromboprophylaxis in all COVID-19 inpatients, but there was heterogeneity in the suggested intensity of thromboprophylaxis: seven advised considering intensified doses of heparin according to the clinical or biological severity of the disease, especially in the ICU setting. Conclusions: Venous thromboembolism very commonly complicates the clinical course of inpatients with COVID-19, despite thromboprophylaxis. The risk appears highest among critically ill inpatients. We found no estimates of risks among outpatients. Many questions remain unresolved, as delineated by the heterogeneity of national and international guidelines. This situation calls for fast randomised clinical trials, comparing different schemes of thromboprophylaxis in COVID-19 inpatients. 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: Physician-related barriers to communication and patient- and family-centred decision-making towards the end of life in intensive care: a systematic review Author(s): Mieke Visser, Luc Deliens, and Dirk Houttekier Publisher or Source: Critical Care Type of Media: Medical Journal Media Originally for: Critical Care Physicians Country of Origin: Belgium Primary Focus of Media: Pre-Use of PICS Designation COVID-19 Related: No Description: Introduction Although many terminally ill people are admitted to an intensive care unit (ICU) at the end of life, their care is often inadequate because of poor communication by physicians and lack of patient- and family-centred care. The aim of this systematic literature review was to describe physician-related barriers to adequate communication within the team and with patients and families, as well as barriers to patient- and family-centred decision-making, towards the end of life in the ICU. We base our discussion and evaluation on the quality indicators for end-of-life care in the ICU developed by the Robert Wood Johnson Foundation Critical Care End-of-Life Peer Workgroup. Method Four electronic databases (MEDLINE, Embase, CINAHL and PsycINFO) were searched, using controlled vocabulary and free text words, for potentially relevant records published between 2003 and 2013 in English or Dutch. Studies were included if the authors reported on physician-related and physician-reported barriers to adequate communication and decision-making. Barriers were categorized as being related to physicians’ knowledge, physicians’ attitudes or physicians’ practice. Study quality was assessed using design-specific tools. Evidence for barriers was graded according to the quantity and quality of studies in which the barriers were reported. Results Of 2,191 potentially relevant records, 36 studies were withheld for data synthesis. We determined 90 barriers, of which 46 were related to physicians’ attitudes, 24 to physicians’ knowledge and 20 to physicians’ practice. Stronger evidence was found for physicians’ lack of communication training and skills, their attitudes towards death in the ICU, their focus on clinical parameters and their lack of confidence in their own judgment of their patient’s true condition. Conclusions We conclude that many physician-related barriers hinder adequate communication and shared decision-making in ICUs. Better physician education and palliative care guidelines are needed to enhance knowledge, attitudes and practice regarding end-of-life care. Patient-, family- and health care system–related barriers need to be examined. 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: Canada falls short in post-ICU care for COVID-19 patients Author(s): Elianna Lev Publisher or Source: Yahoo Sports Type of Media: Newspaper Article Media Originally for: General Public Country of Origin: Canada Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: Yes Description: For COVID-19 patients who’ve been treated in the intensive care unit (ICU) and survived the virus, the road to full recovery isn’t straightforward. While the long-term effects of the virus are still unclear, there’s also a lot more to learn about what life after COVID-19 will look like for those who are experiencing the worst of it. Researchers at the University of British Columbia are examining the type of long-term support that’s needed for patients who’ve been sent to the ICU. 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: Best practices for mechanical ventilation in patients with ARDS, COVID-19 Author(s): University of Michigan Publisher or Source: Medical Xpress Type of Media: Newspaper Article Media Originally for: Critical Care Physicians,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: It's a decision being made thousands of times over inside hospitals all around the country: is it time to place a patient struggling to breathe on a ventilator? For all of the attention ventilators have received during the COVID-19 pandemic, deciding when to place patients on them—and when to take them off—is complex. Michigan Medicine researchers have been investigating best practices for mechanical ventilation for years, never knowing how applicable their work would become. 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: Post-Intensive Care Unit Syndrome: An Overview Author(s): Rondall Keith Lane, MD, MPH Publisher or Source: UCSF School of Medicine Type of Media: PowerPoint 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: These slides help the medical student understand the types of PICS, what makes up PICS, the “burden of survivorship” and some novel interventions for the treatment of 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: Anxiety, Depression and Post Traumatic Stress Disorder after critical illness: a UK-wide prospective cohort study Author(s): Robert Hatch, Duncan Young, Vicki Barber, John Griffiths, David A. Harrison and Peter Watkinson. Publisher or Source: Critical Care Type of Media: Medical Research 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: Post Traumatic Stress Disorder (PTSD) COVID-19 Related: No Description: Survivors of intensive care are known to be at increased risk of developing longer-term psychopathology issues. We present a large UK multi centre study assessing the anxiety, depression and post-traumatic stress disorder (PTSD) caseness in the first year following discharge from an intensive care unit (ICU). 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.