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    Pages (395)
    • Epilepsies: diagnosis and management

      VIEW SELECTED LIBRARY MEDIA Name of Media: Epilepsies: diagnosis and management 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 guideline covers diagnosing, treating and managing epilepsy and seizures in children, young people and adults in primary and secondary care. It offers best practice advice on managing epilepsy to improve health outcomes so that people with epilepsy can fully participate in daily life. If Media is a PDF, Article, Photo, or Chart, Click Icon: If Media is a Video, 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. Back to Search Page

    • Normothermic extracorporeal preservation of hearts for transplantation following donation after brainstem death

      VIEW SELECTED LIBRARY MEDIA Name of Media: Normothermic extracorporeal preservation of hearts for transplantation following donation after brainstem death 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: Evidence-based recommendations on normothermic extracorporeal preservation of hearts for transplant after brainstem death. This technique is used to store a donor heart for longer before being transplanted. If Media is a PDF, Article, Photo, or Chart, Click Icon: If Media is a Video, 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. Back to Search Page

    • BTS Guideline for diagnostic flexible bronchoscopy in adults

      VIEW SELECTED LIBRARY MEDIA Name of Media: BTS Guideline for diagnostic flexible bronchoscopy in adults Author(s): IA Du Rand, J Blaikley, R Booton, N Chaudhuri, V Gupta, S Khalid, S Mandal, J Martin, J Mills, N Navani, NM Rahman, JM Wrightson, M Munavvar Publisher or Source: Thorax- AN INTERNATIONAL JOURNAL OF RESPIRATORY MEDICINE Type of Media: Medical Journal 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: This guideline was formulated following consultation with stakeholders from the medical and nursing professions, patient groups and healthcare management. Basic diagnostic procedures in adults using a flexible bronchoscope are included in the guideline. Topics covered in the guideline: Monitoring of a patient during the procedure. Specific precautions, contraindications and complications. Sedation, premedication and topical anaesthesia. FB in specific patient groups. Role of bronchoscopy in infections. FB in the ICU. Cleaning and disinfection of equipment. Staffing and staff safety. Diagnostic accuracy and specific procedures. Patient satisfaction and patient care. Topics not covered in the guideline Training in bronchoscopy (The BTS is producing separate guidance on training). Advanced diagnostic and therapeutic FB.3 Rigid bronchoscopy. FB used for intubation, percutaneous tracheostomy placements and intraoperative complications. Paediatric FB. FB performed under general anaesthetic. If Media is a PDF, Article, Photo, or Chart, Click Icon: If Media is a Video, 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. Back to Search Page

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    Blog Posts (6)
    • German Research Study: Predictors of MDD following ICU of Chronically Critically Ill Patients

      "Thank you Hindawi for providing open access publishing for the scientific community." Take Aways 1. One of 5 ICU patients suffered from Major Depressive Disorder. 2. Perceived helplessness, recalled experiences of a traumatic event from the ICU, symptoms of acute stress disorder, and the diagnosis of posttraumatic stress disorder (PTSD) after ICU could be identified as significant predictors of MDD August 1, 2018 Objective of Study: Major depressive disorder (MDD) is a common condition following treatment in the Intensive Care Unit (ICU). Long term data on MDD in chronically critically ill (CCI) patients are scarce. Hence, the primary aim of the present study was to investigate the frequency and predictors of MDD after intensive care of CCI patients. Materials and Methods. In a prospective cohort study, patients with long-term mechanical ventilation requirements (n. 131) were assessed with respect to a diagnosis of MDD,using the Structured Clinical Interview for DSM-IV, three and six months after the transfer from acute ICU to post-acute ICU. Sociodemographic, psychological, and clinical risk factors with p values≤ 0.1 were identified in a univariate logistic regression analysis and entered in a multivariable logistic regression model. A mediator analysis was run using the bootstrapping method,testing the mediating effect of perceived helplessness during the ICU stay, between there called traumatic experience from the ICU and a post-ICU MDD. Results. 17.6% (n. 23) of the patients showed a full-or subsyndromal MDD. Perceived helplessness, recalled experiences of a traumatic event from the ICU, symptoms of acute stress disorder, and the diagnosis of posttraumatic stress disorder (PTSD) after ICU could be identified as significant predictors of MDD. In a mediator analysis, perceived helplessness could be proved as a mediator. Conclusions of Study: Every fifth CCI patient suffers from MDD up to six months after being discharged from ICU. Particularly, perceived helplessness during the ICU stay seems to mainly affect the long-term evolvement of MDD. CCI patients with symptoms of acute stress disorder/PTSD should also be screened for MDD. Details of Study: The primary aim of the study was to investigate the frequency of MDD, using a Structured Clinical Interview and, secondly, to investigate risk factors of MDD in CCI patients. We hypothesize that symptoms of acute stress disorder are significant risk factors for the development of a MDD. Moreover, perceived helplessness during the ICU stay is assumed to mediate the impact of the recalled experience of a traumatic event from the ICU treatment on the occurrence of post-ICU MDD. All patients gave written informed consent. All patients meeting the following mentioned criteria were consecutively enrolled at the Bavaria Clinic Kreischa, a rehabilitation hospital with post-acute ICUs for ventilator weaning. Criteria included: Principal diagnosis of a critical illness polyneuropathy (or critical illness myopathy (with or without sepsis, between 18 and 75 years, a minimum stay of six days in ICU, sufficient German language skills, informed consent, and a negative evaluation of the delirium assessment, confusion assessment method for the Intensive Care Unit (CAM-ICU). Cognitively or sensory impaired patients (e.g., positive CAM-ICU and deaf-muteness) and patients with stupor, with insufficient German language skills, and with rapidly terminal disease states or infaust prognosis (e.g., malignancy) were excluded from the present study. CCI patients were interviewed at three different times by trained research assistants.e first time was face-to-face at the bedside within four weeks after transfer from the acute ICU. Follow-up data were assessed via telephone interview three and six months after the transfer from acute ICU to post-acute ICU. Data on the course and predictors of PTSD in CCI patients following ICU have already been published elsewhere. Results Of the 352 potentially eligible CCI patients, 1. 131 (61.8%) patients could be followed up to six months after the transfer from acute ICU. 2. Patients who were followed up had a median age of 61.2 years (range 25.6–70.8). 3. Most patients were male (71.8%), were married orcohabitated (71.1%), and were educated 10 years or more (68.5%). 4. Two thirds of the patients had a diagnosis of sepsis and were treated for acute respiratory insufficiency 5. (38.2%), stayed significantly longer in ICU, were more often educated less than 10 years, and showed significantly lower Barthel indices, both at discharge from post-acute ICU and from rehabilitation hospital. 6. In addition, they had more often pneumonia, chronic kidney disease, and neurological disorders, and presented with a significantly higher number of secondary diagnoses. Of the N. 131 followedup CCI patients, n 23 (17.6%) patients showed a full syndromal or subsyndromal manifestation of a MDD At t2/t3, n. 6 (4.9%)/n. 6 (5.5%) of the CCI patients were diagnosed with full-syndromal MDD. Frequencies of MDD did not significantly differ between t2 and t3 (McNemar test. Gloria-BeatriceWintermann and Katja Petrowski, Jenny Rosendahl, Kerstin Weidner, Bernhard Strau Department of Psychotherapy and Psychosomatic Medicine, Medizinische Fakult¨at Carl Gustav Carus, Technische Universit¨at Dresden, Dresden, Germany Center for Sepsis Control and Care, Jena University Hospital, Friedrich-Schiller University, Jena, Germany Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Friedrich-Schiller University, Jena, Germany 4Institute of Medical Psychology and Medical Sociology, Clinic and Polyclinic for Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University, Mainz, Germany

    • Road to Recovery after Serious COVID-19

      Learn more, read the recent article.

    • Welcome to All, from PostICU Co-Founder Jim Cannon

      In late September 2005, Post ICU, Inc. co founder Jim Cannon walked into his community hospital to undergo a test his doctor assured him posed only a 2 percent chance of finding a problem. Expecting to be back to work before noon, he was in fact escorted out of the hospital in a wheelchair 8 days later. Basic recovery took more than a year. During this time, a disturbing set of new health problems emerged that continue to plague him today. These problems were not diagnosed as post-intensive care syndrome (PICS) for more than a decade. During these years, traditional medical care professionals provided little help despite Jim’s persistent pleas. Roughly 5 years into his recovery, Jim initiated, with the support of his wife, a number of coping mechanisms to live with his new and seemingly permanent physical, mental and cognitive impairments. One of his self-initiated therapies involved reconstructing a written record of his experiences. Over the years, Jim wrote and rewrote dozens of diary entries. Some were based on examinations of his actual medical records. Some were based on interviews with other players in the drama, including several doctors and his family. Most were based on his own memories, including remembrances from being in the throes of death. The diary entries weren’t edited or vetted by medical experts to ensure accuracy. They were not professional, but they had one profound effect: Jim felt better after writing them. In the last few years, use of patient diaries has been promoted by many in the medical community as an important therapeutic tool to prevent and ease the effects of PICs. A number of hospitals now encourage ICU patients to start diaries, and studies are underway to access their effectiveness. The results to date are unclear, but appear promising. Since co-founding Post ICU, Inc. with Rob Rainer, Jim has been reviewing and organizing his diary entries chronologically and doing some editing to make them more readable. They are presented in this blog, Jim’s Story. He is undertaking this project because working with his diary still helps him recover. More importantly, however, is his hope that they will help other PICS sufferers clarify and cope with their own experiences and inspire them to tap into the healing powers diaries offer. Welcome!

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    Services (2)
    • PICS Expert Consultation

      Meet with one of our non-medical professionals to ask any questions about PICS, available services, our research library, articles and other materials of interest, PICS Clinics, etc.

    • PICS Group Discussion

      Opportunity to chat with other former ICU patients and their family members about ICU and post ICU experiences.

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    Forum Posts (2)
    • If you have been a patient in a ICU, were you (or your caregiver or a family member) informed about PICS during or prior to your discharge?

      This question goes to the heart of PostICU's Members greatest concern: How do people experiencing PICS symptoms learn that that PICS is the cause of their symptoms? Is it because they were informed about PICS in the hospital? Or their PCPs? Or a medical specialist of some sort? OR DO THEY NEVER FIND OUT?

    • Welcome to the PostICU, Inc. Members Only Forum

      Please feel free to share your thoughts, ask questions, share your story. The PostICU Forum is the place to be to learn about PICS and to help us make plans to provide assistance to people experiencing PICS. Down the road, we hope to find a place in the critical care arena to add our recommendation for ways to improve the likely outcome for people who spend time in the ICU. We believe that by working with critical care professionals, we can find a number of ways to better educate ICU patients before they are discharged about PICS. We also believe that there would be a long term cost-benefit and health benefit if hospitals made arrangements to add Post ICU Physicians & Nurses to their aftercare programs, to follow up with discharged ICU patients. What are your thoughts on this subject?

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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.

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