Click to Return to Search Page VIEW SELECTED LIBRARY MEDIA Name of Media: Prognosis of cirrhotic patients admitted to intensive care unit: a meta-analysis Author(s): Weil, D., Levesque, E., McPhail, M., Cavallazzi, R., Theocharidou, E., Cholongitas, E., Galbois, A., Pan, H. C., Karvellas, C. J., Sauneuf, B., Robert, R., Fichet, J., Piton, G., Thevenot, T., Capellier, G., Di Martino, V. Publisher or Source: Annals Of Intensive Care Type of Media: Medical Research Media Originally for: Critical Care Physicians Country of Origin: France Primary Focus of Media: Pre-Use of PICS Designation COVID-19 Related: No Description: Background: The best predictors of short- and medium-term mortality of cirrhotic patients receiving intensive care support are unknown. Methods: We conducted meta-analyses from 13 studies (2523 cirrhotics) after selection of original articles and response to a standardized questionnaire by the corresponding authors. End-points were in-ICU, in-hospital, and 6-month mortality in ICU survivors. A total of 301 pooled analyses, including 95 analyses restricted to 6-month mortality among ICU survivors, were conducted considering 249 variables (including reason for admission, organ replacement therapy, and composite prognostic scores). Results: In-ICU, in-hospital, and 6-month mortality was 42.7, 54.1, and 75.1%, respectively. Forty-eight patients (3.8%) underwent liver transplantation during follow-up. In-ICU mortality was lower in patients admitted for variceal bleeding (OR 0.46; 95% CI 0.36-0.59; p < 0.001) and higher in patients with SOFA > 19 at baseline (OR 8.54; 95% CI 2.09-34.91; p < 0.001; PPV = 0.93). High SOFA no longer predicted mortality at 6 months in ICU survivors. Twelve variables related to infection were predictors of in-ICU mortality, including SIRS (OR 2.44; 95% CI 1.64-3.65; p < 0.001; PPV = 0.57), pneumonia (OR 2.18; 95% CI 1.47-3.22; p < 0.001; PPV = 0.69), sepsis-associated refractory oliguria (OR 10.61; 95% CI 4.07-27.63; p < 0.001; PPV = 0.76), and fungal infection (OR 4.38; 95% CI 1.11-17.24; p < 0.001; PPV = 0.85). Among therapeutics, only dopamine (OR 5.57; 95% CI 3.02-10.27; p < 0.001; PPV = 0.68), dobutamine (OR 8.92; 95% CI 3.32-23.96; p < 0.001; PPV = 0.86), epinephrine (OR 5.03; 95% CI 2.68-9.42; p < 0.001; PPV = 0.77), and MARS (OR 2.07; 95% CI 1.22-3.53; p = 0.007; PPV = 0.58) were associated with in-ICU mortality without heterogeneity. In ICU survivors, eight markers of liver and renal failure predicted 6-month mortality, including Child-Pugh stage C (OR 2.43; 95% CI 1.44-4.10; p < 0.001; PPV = 0.57), baseline MELD > 26 (OR 3.97; 95% CI 1.92-8.22; p < 0.0001; PPV = 0.75), and hepatorenal syndrome (OR 4.67; 95% CI 1.24-17.64; p = 0.022; PPV = 0.88). Conclusions: Prognosis of cirrhotic patients admitted to ICU is poor since only a minority undergo liver transplant. The prognostic performance of general ICU scores decreases over time, unlike the Child-Pugh and MELD scores, even recorded in the context of organ failure. Infection-related parameters had a short-term impact, whereas liver and renal failure had a sustained impact on mortality. Keywords: CLIF-SOFA; Cirrhosis; Extrahepatic organ failure; MELD; Mortality; Organ replacement therapy; Prognostic scores. 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: Disparities in Post-Intensive Care Syndrome During the COVID-19 Pandemic: Challenges and Solutions Author(s): Moses J.E. Flash, BA, Shawn F. Johnson, BS, Max Jordan Nguemeni Tiako, MS, Aswita Tan-McGrory, MBA, MSPH, Joseph R. Betancourt, MD, Daniela J. Lamas, MD, George A. Alba, MD Publisher or Source: Massachusetts Medical Society 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: United Kingdom of Great Britain and Northern Ireland (the) Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: Yes Description: Systemic disparities place minority populations at the greatest risk of contracting and dying from Covid-19, and there is robust literature documenting how structural racism has adversely impacted the well-being of Black, Latinx, and Indigenous people. To date, the predominant focus has been on how disparities impact patients before and during hospitalization with Covid-19. However, disparities in the post-hospitalization period remain unaddressed. Specifically, patients recovering from Covid-19 are at risk for a host of physical, cognitive, and psychiatric sequelae of critical illness, collectively termed “post-intensive care syndrome (PICS).” In the present article, we review the literature on disparities in PICS, highlight the personal toll of Covid-19 on our patients, and suggest solutions to anticipated challenges. We outline a three-pronged approach involving (1) the prevention of critical illness, (2) the deployment of short-term post-hospitalization initiatives, and (3) the implementation of long-term post-hospitalization and community-based solutions. 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: Organ donation for transplantation: improving donor identification and consent rates for deceased organ donation Author(s): The National Institute for Health and Care Excellence Publisher or Source: The National Institute for Health and Care Excellence Type of Media: Medical Professional Education Media Originally for: Critical Care Physicians, General Medical Professionals Country of Origin: United Kingdom Primary Focus of Media: Pre-Use of PICS Designation COVID-19 Related: No Description: A significant proportion of people in England and Wales would wish to donate their organs after death for the purpose of transplantation. This guideline recognises the complexities that arise owing to the majority of potential organ donors lacking the capacity to be directly involved in decision making at the time of their death. This guideline seeks to promote the identification and fulfilment of these wishes through: • more effective and expedient identification and referral of potential organ donors • a more informed, considered and timely approach to consent for donation that is based primarily on identifying the wishes of the individual whenever known and however recorded. 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: Nine Months, 28M Cases: How COVID-19’s Clinical Landscape Has Changed Author(s): Narayana Subramaniam, Dr. Publisher or Source: The Wire Science Type of Media: Newspaper Article Media Originally for: General Public Country of Origin: India Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: Yes Description: First described as a cluster of viral pneumonia cases of unknown cause in the Hubei province of China, COVID-19 has rapidly spread across the globe, causing widespread illness and death, with unparalleled global social and economic disruption. As the disease spread like wildfire, clinical patterns, mortality rate, infectivity and complications seemed to vary considerably from place to place. In an attempt to better characterise this disease, there have been over 50,000 scientific articles published on COVID-19. Many of them became headlines for public consumption with little to no context. As larger amounts of high-quality scientific data became available, our understanding of the disease and its impact has undergone significant refinement. 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: The Efficacy of Albumin Dialysis in the Reversal of Refractory Vasoplegic Shock Due to Amlodipine Toxicity Author(s): Randi L. Connor-Schuler, MD; Jennifer M. Carr, MS; Matthew S. Reaven, MD; Bob T. Bridgman, PharmD; Deepa M. Patel, MD; Ram M. Subramanian, MD Publisher or Source: Critical Care Explorations 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: United States of America (the) Primary Focus of Media: Pre-Use of PICS Designation COVID-19 Related: No Description: Objectives: Calcium channel blockers are highly protein-bound medications frequently used in the management of hypertension. Overdose results in severe hypotension and is the fourth most common cause of toxicity-related deaths in the United States. Management is mostly supportive, with currently no standard role for targeted drug removal. The protein-bound nature of these medications presents the option of utilizing albumin dialysis for their removal and for the reversal of associated shock. Design and Subjects: We present two cases of life-threatening intentional amlodipine overdoses successfully treated with albumin dialysis. Both patients experienced profound distributive shock in the setting of preserved cardiac contractility that was refractory to maximal vasoactive agent support. Interventions and Results: After initiation of albumin dialysis, the patients showed rapid hemodynamic improvement and were able to be weaned off vasopressor support. Conclusions: These cases demonstrate the safety and efficacy of albumin dialysis in the management of near-fatal calcium channel blocker overdoses related to amlodipine and offer an additional therapeutic option apart from conventional supportive care. Importantly, these cases were not associated with impaired cardiac contractility, thereby making venoarterial extracorporeal membrane oxygenation a less preferable option. Furthermore, this therapeutic benefit of albumin dialysis can potentially be extended to the management of toxicity related to other highly protein-bound drugs and toxins. 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: What You Need to Know About PICS Author(s): University of Michigan Health System (UMHS) Publisher or Source: University of Michigan Type of Media: One-Pager Media Originally for: Former ICU Patients, Former ICU Patients' Family Members, Friends or Caregivers, General Public Country of Origin: United States Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: No Description: Post-intensive care syndrome, also known as PICS, is a group of symptoms that may occur in people after discharge from an Intensive Care Unit (ICU). PICS can affect daily living, slow thinking, or cause difficulties with processing thoughts. 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: AHA News: Hospice Candidate at 2, She's Now 13 and Thriving Author(s): Suzanne Marta Publisher or Source: HealthDay 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: MONDAY, Jan. 25, 2021 (American Heart Association News) -- Rosemary "Rosie" Veltz was "medically maxed out." That was the term the doctors used six months after a third surgery to correct a heart defect that left her struggling to breathe while her lungs continued to fill with fluid. 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 Covid-19 is not the end of the story Author(s): Shamim Ahmed , Gias U Ahsan , Sharmin Majumder , Salma Hasan Publisher or Source: The Daily Star Type of Media: Newspaper Article Media Originally for: General Public Country of Origin: Bangladesh Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: Yes Description: Covid-19, caused by the novel coronavirus named SARS-CoV-2, has led to a pandemic that is increasing the burden of mortality and morbidities throughout the world. It has brought many challenges including prevalence of disability and caused major disruption to healthcare services. About 12 million people around the globe have been infected by the virus so far, with a vast majority of them already recovered. However, half a million valuable lives have been lost due to this deadly disease. In addition, the virus may have a lasting effect on the body in general—as well as in major organs including lungs—for those who have survived the infection. 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: Relationship Between ICU Length of Stay and Long-Term Mortality for Elderly ICU Survivors Author(s): MOITRA, V. K., GUERRA, C., LINDE-ZWIRBLE, W. T. AND WUNSCH, H Publisher or Source: National Center for Biotechnology Information Type of Media: Medical Journal 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: This article is to evaluate the association between length of ICU stay and 1-year mortality for elderly patients who survived to hospital discharge in the United States. 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: Recognizing the Critical Need for Psychiatric Care Author(s): Sophia Wang, MD , You Na P. Kheir, MD , Duane Allen, MD , Babar Khan, MD, MPH Publisher or Source: Psychiatric Times Type of Media: Medical Journal, Newspaper Article Media Originally for: General Public Country of Origin: United States Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: No Description: Post-intensive care syndrome (PICS) is a rapidly growing phenomenon in older adults. As survival rates from ICU hospitalizations have increased over the past few decades, the long-term cognitive, psychological, and physical sequelae of the illness have become a major challenge in critical care medicine. More than half of all ICU survivors suffer from at least one PICS-related impairment, and these effects can persist as long as 5 or more years. PICS has become an increasingly important phenomenon in older adults for several reasons. First, the number of older adults with critical illness is rapidly increasing as the population ages and now accounts for about 50% of ICU admissions. Second, more than 70% of older adults hospitalized in the ICU develop delirium, which is a major risk factor for ICU-acquired cognitive impairments. Third, cognitive and functional impairment before an ICU hospitalization increases the likelihood of cognitive and functional decline afterward. 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: Evaluating clinical pharmacist involvement in a COVID-19 intensive care recovery clinic Author(s): Stephen Ward, Rosalind O'Reilly, and Paula Crawford Publisher or Source: The Pharmaceutical Journal 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: United Kingdom of Great Britain and Northern Ireland (the) Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: Yes Description: Introduction: Post-intensive care syndrome (PICS) is associated with an increased risk of mortality. Critical illness recovery clinics have been recommended by the Faculty of Intensive Care Medicine (FICM) as an approach to manage the complexity of PICS. The COVID-19 pandemic has provided many healthcare challenges, not least how to support those who have survived critical illness related to the virus. Recent guidance from the FICM also recommends pharmacist involvement in rehabilitation and recovery clinics for patients discharged from hospital following COVID-19 critical illness. This evaluation was undertaken to determine the impact of the inclusion of a clinical pharmacist in this setting. Method: All patients discharged following a COVID-19-related intensive care unit (ICU) admission in the Belfast Health and Social Care Trust, Northern Ireland, from 26 March 2020 to 15 May 2020 were offered enrolment in a rehabilitation and recovery programme. This involved an initial 6-week remote review, followed by a multidisciplinary face-to-face assessment at 12 weeks post-discharge. Each healthcare professional at the clinic contributed to an overall treatment plan, which was communicated to the patient’s GP. The clinical pharmacist carried out a structured medicines optimisation review and identified medication-related interventions, which were recorded and graded according to the Eadon criteria. Cost savings resulting from these interventions were estimated using the model described by the University of Sheffield School of Health and Related Research (ScHARR), a type of economic modelling that uses literature-based values of the costs of medication errors and compares this with the benefits of different medication-related interventions. Results: A total of 42 patients were discharged during this period following COVID-19 ICU admission, with 93% (n=39) agreeing to enrolment in the follow-up clinic. Medication-related interventions were identified in 82% (n=32) of the 39 patients. The most common medication-related intervention was patient education, accounting for 38% (n=24) of all interventions. Discussion: Analgesics were the class of medications most associated with requiring an intervention and 65% of interventions were graded as significant, resulting in improved care standards (i.e. Eadon ≥grade 4). Clinical pharmacist interventions yielded potential savings of £4.20–£8.59 per £1 invested, based on total potential savings in the range of £6,204–£12,699, with a total pharmacist investment of £1,478. Conclusion: Clinical pharmacists have a role in medicines optimisation for patients recovering from COVID-19-related critical illness. Most interventions by a clinical pharmacist in a post-ICU recovery clinic were related to symptom management and patient education. Their role in this setting can help rationalise medicines and improve patients’ understanding, resulting in potential healthcare-related cost-savings and safer patient-centred care. Keywords: Clinical pharmacy, COVID-19, critical care, integrated care, intensive care, interventions, medicines optimisation, outpatient clinic. 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: New report outlines scale of challenge for NHS Author(s): Gemma Mitchell Publisher or Source: Nursing Times Type of Media: Newspaper Article Media Originally for: General Public Country of Origin: United Kingdom of Great Britain and Northern Ireland (the) Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: Yes Description: Health professionals urgently need more information and training to respond to the rising numbers of people in the UK living with so-called 'long Covid', which may not be one condition but several different syndromes, according to researchers. 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.