Click to Return to Search Page VIEW SELECTED LIBRARY MEDIA Name of Media: The APACHE III Prognostic System: Risk Prediction of Hospital Mortality for Critically III Hospitalized Adults Author(s): KNAUS, W. A., WAGNER, D. P., DRAPER, E. A., ZIMMERMAN, J. E., BERGNER, M., BASTOS, P. G., SIRIO, C. A., MURPHY, D. J., LOTRING, T., DAMIANO, A. AND HARRELL, F. E. Publisher or Source: CHEST Type of Media: Medical Journal Media Originally for: Nurses and/or Other Critical Care Medical Professionals Country of Origin: United States Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: No Description: The objective of this study was to refine the APACHE (Acute Physiology, Age, Chronic Health Evaluation) methodology in order to more accurately predict hospital mortality risk for critically ill hospitalized adults. We prospectively collected data on 17,440 unselected adult medical/surgical intensive care unit (ICU) admissions at 40 US hospitals (14 volunteer tertiary-care institutions and 26 hospitals randomly chosen to represent intensive care services nationwide). We analyzed the relationship between the patient's likelihood of surviving to hospital discharge and the following predictive variables: major medical and surgical disease categories, acute physiologic abnormalities, age, preexisting functional limitations, major comorbidities, and treatment location immediately prior to ICU admission. The APACHE III prognostic system consists of two options: (1) an APACHE III score, which can provide initial risk stratification for severely ill hospitalized patients within independently defined patient groups; and (2) an APACHE III predictive equation, which uses APACHE III score and reference data on major disease categories and treatment location immediately prior to ICU admission to provide risk estimates for hospital mortality for individual ICU patients. A five-point increase in APACHE III score (range, 0 to 299) is independently associated with a statistically significant increase in the relative risk of hospital death (odds ratio, 1.10 to 1.78) within each of 78 major medical and surgical disease categories. The overall predictive accuracy of the first-day APACHE III equation was such that, within 24 h of ICU admission, 95 percent of ICU admissions could be given a risk estimate for hospital death that was within 3 percent of that actually observed (r2 = 0.41; receiver operating characteristic = 0.90). Recording changes in the APACHE III score on each subsequent day of ICU therapy provided daily updates in these risk estimates. When applied across the individual ICUs, the first-day APACHE III equation accounted for the majority of variation in observed death rates (r2 = 0.90, p<0.0001). 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: Chapter 86: Post-Intensive Care Syndrome Author(s): Leonard Lim; and Graciela Soto Publisher or Source: MCGraw-Hill Type of Media: Medical Professional Education Media Originally for: Critical Care Physicians Country of Origin: United States Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: No Description: Over the past decade, survival from critical illness has dramatically increased due to a better understanding of the pathophysiological mechanisms of disease, improved treatment strategies and advancements in medical technology. Several studies have shown improved survival and long-term outcomes in survivors of critically illness. However, surviving the intensive care unit (ICU) stay is just the start of a long road to recovery for a majority of these patients. The discharge from the ICU opens the path to a long journey of challenging physical rehabilitation, mood disorders, cognitive impairment, psychological distress, financial hardship, and caregiver burden and burnout. In recent years there has been a growing recognition of impairments that affect the physical, psychological, social, and emotional aspects of the individual after ICU discharge that may adversely impact daily functioning and quality of life (QOL). Recently, the term “post-intensive care syndrome” (PICS) is used to describe any new or worsening impairments in physical, cognitive, or mental health status arising after critical illness and persisting beyond the acute care hospitalization.1 PICS may persist for months to years after hospital discharge. Most impairments will diminish with time but some may linger on until the patient’s actual demise. This chapter will explore in detail the different domains affected in PICS, its impact on the individual and society, and offer insights into future developments. 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: Economic evaluation of chlorhexidine-impregnated sponges for preventing catheter-related infections in critically ill adults in the Dressing Study Author(s): University of York- the Centre for Reviews and Dissemination Publisher or Source: NHS Economic Evaluation Database (NHS EED) Type of Media: Medical Professional Education 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: The study examined the cost-effectiveness of chlorhexidine gluconate-impregnated sponges (CHIGIS) for arterial and central venous catheters for prevention of catheter-related infections in critically ill adults using data from a recent clinical trial. The authors concluded that the CHGIS strategy reduced the rate of MCRI and saved costs from the perspective of an intensive care unit. The analysis was appropriately carried out using a micro-costing approach alongside a randomised controlled trial. The authors’ conclusions appear robust. 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: PTSD after intensive care: A guide for therapists Author(s): the Oxford Centre for Anxiety Disorders and Trauma Publisher or Source: University of Oxford Type of Media: Medical Professional Education Media Originally for: Critical Care Physicians, 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: Yes Description: The COVID-19 pandemic has led to vastly increased admissions into intensive care units (ICU). Around one in four ICU patients develop PTSD symptoms after the admission. Other disorders, including depression and various anxiety disorders are also common.This guide aims to provide information for therapists working with patients who have developed PTSD after an ICU admission, or a similar medical environment. 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: Surveillance of healthcare-associated infections and prevention indicators in European intensive care units Author(s): Anne Savey, Alain Lepape, Mercedes Palomar, Antonella Agodi, Michael Hiesmayr, Anna-Pelagia Magiorakos, Pete Kinross, Tommi Kärki, Diamantis Plachouras, Carl Suetens Publisher or Source: European Centre for Disease Prevention and Control Type of Media: Medical Professional Education Media Originally for: Critical Care Physicians Country of Origin: Sweden Primary Focus of Media: Pre-Use of PICS Designation COVID-19 Related: No Description: This protocol is for hospitals participating in the national/regional surveillance of healthcare-associated infections in intensive care units across Europe. It aims to describe methods for participating ICUs and national coordinating centres to ensure standardisation of definitions, data collection and reporting procedures. This protocol is an update of a previous version 2.1 released in June 2015. 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: Families of COVID-19 patients in intensive care may face own health challenges Author(s): Mackenzie Bean Publisher or Source: Families of COVID-19 patients in intensive care may face own health challenges 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 for Families (PICS-F) COVID-19 Related: Yes Description: Some critical care physicians say they're concerned that long intensive care unit stays will not only have physical and mental health consequences for COVID-19 patients, but also their family members, according to a Kaiser Health News article published in The Washington Post. 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-Traumatic Stress Disorder After a Serious Illness Author(s): Sepsis Alliance Publisher or Source: Sepsis Alliance Type of Media: One-Pager Media Originally for: General Public Country of Origin: United States Primary Focus of Media: Post Traumatic Stress Disorder (PTSD) COVID-19 Related: No Description: Post-traumatic stress disorder (PTSD) can occur after someone experiences a traumatic event. The actual event can be short-lived, such as witnessing an accident or being a victim of a crime, or it can be long-term, like living in an abusive situation or being in a war zone. Not everyone who experiences such events develops PTSD and researchers don’t know why some people do while others don’t. 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: Baton Rouge General offers post-recovery support services for COVID survivors Author(s): WBRZ Staff Publisher or Source: WBRZ 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: BATON ROUGE – According to Louisiana's Department of Health, about 149,640 residents have recovered from novel coronavirus since the outbreak began this year. While reports of physical recovery are encouraging, for many survivors, this physical recovery is only the initial step in a journey to fully restored health. After successfully battling the virus so as to move out of quarantine and return to work, a number of patients report that their battle continues emotionally. This is often the case for the sickest of the sick who required time in the ICU and intubation. These patients may face "post-intensive care syndrome" (PICS) that could manifest as a combination of physical, cognitive, and mental health impairments following an ICU stay for a critical illness. This is why Baton Rouge General (BRG) has started a 'Coping After COVID' support group for survivors who are struggling to get back to normal life, as lingering symptoms and months of illness can contribute to anxiety and depression. 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: Decontamination of the mouth or digestive tract was not linked to reductions in drug-resistant bloodstream infections in the intensive care unit Author(s): the University of Southampton and Bazian Publisher or Source: NIHR Dissemination Centre Type of Media: Medical Professional Education 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: Decontamination strategies to remove potentially harmful bacteria from the mouth, throat and gut of critically ill patients don’t reduce the risk of intensive care unit-acquired bloodstream infections or deaths from bacteria that were resistant to antibiotics. The study was carried out in 13 intensive care units across Europe, including the UK, with moderate to high levels of antibiotic resistance (extended resistance in more than 5% of all bloodstream infections). This fills an important gap in the evidence as most previous studies have been in units with lower levels of resistant organisms. Infections with multi-drug resistant gram-negative bacteria are a frequent problem for ventilated patients on intensive care wards. In this trial of 8,665 patients, the use of chlorhexidine mouthwash, selective digestive tract decontamination, or selective mouth and throat decontamination were compared to standard care, involving daily body washings with chlorhexidine and a hand hygiene improvement programme. The decontamination strategies were not associated with a significant difference in multi-drug resistant bloodstream infections, suggesting that they should not be used in the UK as a strategy to reduce antibiotic resistance in hospitals with similar extended resistance rates. 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: Instruments to measure outcomes of post-intensive care syndrome inoutpatient care settings – Results of anexpert consensus and feasibility field test Author(s): Claudia D Spies , Henning Krampe, Nicolas Paul ,Claudia Denke, Jo ̈rn Kiselev, Sophie K Piper, Jochen Kruppa, Julius J Grunow, Karin Steinecke, Tuba Gu ̈lmez, Kathrin Scholtz, Simone Rosseau, Christiane Hartog, Reinhard Busse, Jo ̈rg Caumanns, Ursula Marschall, Martin Gersch, Christian Apfelbacher, Steffen Weber-Carstens and Bjo ̈rn Weiss Publisher or Source: Journal of the Intensive Care 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: Germany Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: No Description: Background: There is no consensus on the instruments for diagnosis of post-intensive care syndrome (PICS). We present a proposal for a set of outcome measurement instruments of PICS in outpatient care. Methods: We conducted a three-round, semi-structured consensus-seeking process with medical experts, followed each by exploratory feasibility investigations with intensive care unit survivors (n1 1⁄4 5; n2 1⁄4 5; n3 1⁄4 7). Fourteen participants from nine stakeholder groups participated in the first and second consensus meeting. In the third consensus meeting, a core group of six clinical researchers refined the final outcome measurement instrument set proposal. Results: We suggest an outcome measurement instrument set used in a two-step process. First step: Screening with brief tests covering PICS domains of (1) mental health (Patient Health Questionnaire-4 (PHQ-4)), (2) cognition (MiniCog, Animal Naming), (3) physical function (Timed Up-and-Go (TUG), handgrip strength), and (4) health-related quality of life (HRQoL) (EQ-5D-5L). Single items measure subjective health before and after the intensive care unit stay. If patients report new or worsened health problems after intensive care unit discharge and show relevant impairment in at least one of the screening tests, a second extended assessment follows: (1) Mental health (Patient Health Questionnaire-8 (PHQ-8), Generalized Anxiety Disorder Scale-7 (GAD-7), Impact of Event Scale – revised (IES-R)); (2) cognition (Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Trail Making Test (TMT) A and B); (3) physical function (2-Minute Walk Test (2-MWT), handgrip strength, Short Physical Performance Battery (SPPB)); and (4) HRQoL (EQ-5D-5L, 12-Item WHO Disability Assessment Schedule (WHODAS 2.0)). Conclusions: We propose an outcome measurement instrument set used in a two-step measurement of PICS, combining performance-based and patient-reported outcome measures. First-step screening is brief, free-of-charge, and easily applicable by health care professionals across different sectors. If indicated, specialized healthcare providers can perform the extended, second-step assessment. Usage of the first-step screening of our suggested outcome measurement instrument set in outpatient clinics with subsequent transfer to specialists is recommended for all intensive care unit survivors. This may increase awareness and reduce the burden 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: ICU trauma probe: Psychiatrist studies triggers of mental illness in patients Author(s): Zipo-zenkosi Ncokazi Publisher or Source: SowetanLIVE Type of Media: Newspaper Article Media Originally for: General Public Country of Origin: South Africa Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: No Description: Psychiatrists call it post-ICU syndrome, or the development of mental illness after admission to an intensive care unit, which is common in patients around the world. “In addition to the experience of going into ICU, SA patients live in a society with high levels of crime and trauma and many of us have symptoms of post-traumatic stress disorder (PTSD),” said Dr Sarah Boshoff, a psychiatry registrar studying the triggers of PTSD in ICUs. Boshoff is involved in research that stems from a larger cohort study which Dr Elizabeth van der Merwe is conducting at Livingstone Hospital in Port Elizabeth. 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.