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  • Patients' PICS Stories | PostICU, Inc. | United States

    SHARE YOUR PICS EXPERIENCE Submit Your PICS Story Complete and submit this form to share your PICS story with others. You do not have to share your first name. To read other submitters stories, click here . If you would like to share your story by video, please click on the upload video icon. For examples of other people sharing their stories on video, click here . Patient's Stories about PICS Experiences VIDEOS OF PATIENTS' PICS STORIES Patients' PICS Stories on Video

  • the bmj|BMJ 2021;372:n436 | doi: 10.1136/bmj.n4361State of the art reVIeWSevere covid-19 pneumonia: pathogenesis and clinical management

    Click to Return to Search Page VIEW SELECTED LIBRARY MEDIA Name of Media: the bmj|BMJ 2021;372:n436 | doi: 10.1136/bmj.n4361State of the art reVIeWSevere covid-19 pneumonia: pathogenesis and clinical management Author(s): Amy H Attaway, Rachel G Scheraga, Adarsh Bhimraj, Michelle Biehl, Umur Hatipoğlu Publisher or Source: The 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: United States of America (the) Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: Yes Description: Severe covid-19 pneumonia has posed critical challenges for the research and medical communities. Older age, male sex, and comorbidities increase the risk for severe disease. For people hospitalized with covid-19, 15-30% will go on to develop covid-19 associated acute respiratory distress syndrome (CARDS). Autopsy studies of patients who died of severe SARS CoV-2 infection reveal presence of diffuse alveolar damage consistent with ARDS but with a higher thrombus burden in pulmonary capillaries. When used appropriately, high flow nasal cannula (HFNC) may allow CARDS patients to avoid intubation, and does not increase risk for disease transmission. During invasive mechanical ventilation, low tidal volume ventilation and positive end expiratory pressure (PEEP) titration to optimize oxygenation are recommended. Dexamethasone treatment improves mortality for the treatment of severe and critical covid-19, while remdesivir may have modest benefit in time to recovery in patients with severe disease but shows no statistically significant benefit in mortality or other clinical outcomes. Covid-19 survivors, especially patients with ARDS, are at high risk for long term physical and mental impairments, and an interdisciplinary approach is essential for critical illness recovery. 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.

  • OHSU starting specialized program to help treat COVID-19 long-haulers

    Click to Return to Search Page VIEW SELECTED LIBRARY MEDIA Name of Media: OHSU starting specialized program to help treat COVID-19 long-haulers Author(s): Morgan Romero Publisher or Source: KGW.com Type of Media: Newspaper Article Media Originally for: General Public Country of Origin: United States of America (the) Primary Focus of Media: Post Intensive Care Syndrome (PICS) COVID-19 Related: Yes Description: PORTLAND, Ore. — Millions of Americans survive COVID-19, but lingering symptoms can stay with them for months. At Oregon Health & Science University (OHSU), there's a new program to try to treat patients considered long-haulers. It's one of dozens that has opened, or will be opening, in the U.S., as reported by NBC News. So far, it's the only specialized post-COVID clinic we know of in the state of Oregon. OHSU is finalizing its Long COVID-19 Program, which it hopes to launch in about a month. It's a specialized, coordinated approach to care for Oregonians dealing with an illness that doesn't have a known cure, now labeled Post-Acute Sequelae of SARS-CoV-2 infection (PASC). 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.

  • Why 'presumed recovered' doesn't mean you're done with the coronavirus

    Click to Return to Search Page VIEW SELECTED LIBRARY MEDIA Name of Media: Why 'presumed recovered' doesn't mean you're done with the coronavirus Author(s): Woodruff, E. Publisher or Source: The Times-Picayune | The New Orleans Advocate Type of Media: Newspaper Article Media Originally for: General Public Country of Origin: United States Primary Focus of Media: PICS and PICS-F COVID-19 Related: Yes Description: Young, healthy people can suffer for far longer than even a bad flu, a Centers for Disease Control and Prevention study found. One in five adults between the ages of 18 and 34 said they didn't feel back to normal two or three weeks after their diagnosis. "A lot of people don't realize, even if the virus is gone, that doesn't mean you're done with it," said Sullivan. "It's done its damage." 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.

  • Engaging Survivors of Critical Illness in Health Care Assessment and Policy Development

    Click to Return to Search Page VIEW SELECTED LIBRARY MEDIA Name of Media: Engaging Survivors of Critical Illness in Health Care Assessment and Policy Development Author(s): Alison S. Clay and Cheryl Misak Publisher or Source: the American Thoracic 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: Canada Primary Focus of Media: Pre-Use of PICS Designation COVID-19 Related: No Description: Health systems, granting agencies, and professional societies are increasingly involving patients and their family members in the delivery of health care and the improvement of health sciences. This is a laudable advance toward fully patient-centered medicine. However, patient engagement is not a simple matter, either practically or ethically. The complexities include (1) the physical limitations that patients and their family members may have, from traveling to meetings to special dietary needs; (2) the emotional sensitivities patients and their families might experience—from distress at discussions of disease prognosis, outcomes, and therapies to being inexperienced at public speaking; and (3) the fact that advocacy efforts by patients and family members, which may be encouraged at the national level, may threaten individual professionals providing care to individual patients and may result in risk to patients. In this article, a patient-physician and patient-bioethicist set out the obstacles, including ones that they have encountered in their own advocacy efforts. The aim is to survey the practical and ethical landscape so that solutions to various problems may be identified and solved as we move forward in our efforts to involve patients and their families in research, policy, and quality improvement in critical care medicine. 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.

  • Cost-effectiveness of a transplantation strategy compared to melphalan and prednisone in younger patients with multiple myeloma

    Click to Return to Search Page VIEW SELECTED LIBRARY MEDIA Name of Media: Cost-effectiveness of a transplantation strategy compared to melphalan and prednisone in younger patients with multiple myeloma 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: This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. 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.

  • Protocol‐directed sedation versus non‐protocol‐directed sedation in mechanically ventilated intensive care adults and children

    Click to Return to Search Page VIEW SELECTED LIBRARY MEDIA Name of Media: Protocol‐directed sedation versus non‐protocol‐directed sedation in mechanically ventilated intensive care adults and children Author(s): Leanne M Aitken, Tracey Bucknall, Bridie Kent, Marion Mitchell, Elizabeth Burmeister, Samantha J Keogh Publisher or Source: Cochrane Database of Systematic Reviews Type of Media: Medical Journal Media Originally for: Critical Care Physicians Country of Origin: Australia Primary Focus of Media: Pre-Use of PICS Designation COVID-19 Related: No Description: Background The sedation needs of critically ill patients have been recognized as a core component of critical care that is vital to assist recovery and ensure humane treatment. Evidence suggests that sedation requirements are not always optimally managed. Suboptimal sedation, both under‐ and over‐sedation, have been linked to short‐term (e.g. length of stay) and long‐term (e.g. psychological recovery) outcomes. Strategies to improve sedation assessment and management have been proposed. This review was originally published in 2015 and updated in 2018. Objectives To assess the effects of protocol‐directed sedation management compared to usual care on the duration of mechanical ventilation, intensive care unit (ICU) and hospital mortality and other patient outcomes in mechanically ventilated ICU adults and children. Search methods We used the standard search strategy of the Cochrane Anaesthesia, Critical and Emergency Care Group (ACE). We searched the Cochrane Central Register of Controlled trials (CENTRAL) (December 2017), MEDLINE (OvidSP) (2013 to December 2017), Embase (OvidSP) (2013 to December 2017), CINAHL (BIREME host) (2013 to December 2017), LILACS (2013 to December 2017), trial registries and reference lists of articles. (The original search was run in November 2013). Selection criteria We included randomized controlled trials (RCTs) and quasi‐randomized controlled trials conducted in ICUs comparing management with and without protocol‐directed sedation in intensive care adults and children. Data collection and analysis Two authors screened the titles and abstracts and then full‐text reports identified from our electronic search. We assessed seven domains of potential risk of bias for the included studies. We examined clinical, methodological and statistical heterogeneity and used the random‐effects model for meta‐analysis where we considered it appropriate. We calculated the mean difference (MD) for duration of mechanical ventilation and risk ratio (RR) for mortality across studies, with 95% confidence intervals (CIs). Main results We included four studies with a total of 3323 participants (864 adults and 2459 paediatrics) in this update. Three studies were single‐centre, patient‐level RCTs and one study was a multicentre cluster‐RCT. The settings were in metropolitan centres and included general, mixed medical‐surgical, medical only and a range of paediatric units. All four included studies compared the use of protocol‐directed sedation, specifically protocols delivered by nurses, with usual care. We rated the risk of selection bias due to random sequence generation low for two studies and unclear for two studies. The risk of bias was highly variable across the domains and studies, with the risk of selection and performance bias generally rated high and the risk of detection and attrition bias generally rated low. When comparing protocol‐directed sedation with usual care, there was no clear evidence of difference in duration of mechanical ventilation in hours for the entire duration of the first ICU stay for each patient (MD ‐28.15 hours, 95% CI ‐69.15 to 12.84; I2 = 85%; 4 studies; adjusted sample 2210 participants; low‐quality evidence). There was no clear evidence of difference in ICU mortality (RR 0.77, 95% CI 0.39 to 1.50; I2 = 67%; 2 studies; 513 participants; low‐quality evidence), or hospital mortality (RR 0.90, 95% CI 0.72 to 1.13; I2 = 10%; 3 studies; adjusted sample 2088 participants; low‐quality evidence). There was no clear evidence of difference in ICU length of stay (MD ‐1.70 days, 95% CI‐3.71 to 0.31; I2 = 82%; 4 studies; adjusted sample of 2123 participants; low‐quality of evidence), however there was evidence of a significant reduction in hospital length of stay (MD ‐3.09 days, 95% CI ‐5.08 to ‐1.10; I2 = 2%; 3 studies; adjusted sample of 1922 participants; moderate‐quality evidence). There was no clear evidence of difference in the incidence of self‐extubation (RR 0.88, 95% CI 0.55 to 1.42; I2 = 0%; 2 studies; adjusted sample of 1687 participants; high‐quality evidence), or incidence of tracheostomy (RR 0.67, 95% CI 0.35 to 1.30; I2 = 66%; 3 studies; adjusted sample of 2008 participants; low‐quality evidence). Only one study examined incidence of reintubation, therefore we could not pool data; there was no clear evidence of difference (RR 0.65, 95% CI 0.35 to 1.24; 1 study; 321 participants; low‐quality evidence). Authors' conclusions There is currently limited evidence from RCTs evaluating the effectiveness of protocol‐directed sedation on patient outcomes. The four included RCTs reported conflicting results and heterogeneity limited the interpretation of results for the primary outcomes of duration of mechanical ventilation and mortality. Further studies, taking into account differing contextual characteristics, are necessary to inform future practice. Methodological strategies to reduce the risk of bias need to be considered in future 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.

  • Defining Patient and Family Engagement in the Intensive Care Unit

    Click to Return to Search Page VIEW SELECTED LIBRARY MEDIA Name of Media: Defining Patient and Family Engagement in the Intensive Care Unit Author(s): Barbara Sarnoff Lee, L.I.C.S.W.; Kathleen Turner, R.N.; Dominick L. Frosch, Ph.D. Publisher or Source: the American Thoracic 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 States Primary Focus of Media: Post Intensive Care Syndrome for Families (PICS-F) COVID-19 Related: No Description: Patient and family* engagement in the ICU is an active partnership between health professionals and patients and families working at every level of the healthcare system to improve health and the quality, safety, and delivery of healthcare. Arenas for such engagement include but are not limited to participation in direct care, communication of patient values and goals, and transformation of care processes to promote and protect individual respect and dignity. PFE comprises five core concepts: Collaboration, Respect and Dignity, Activation and Participation, Information Sharing, and Decision Making 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.

  • Cognitive therapy for post-traumatic stress disorder following critical illness and intensive care unit admission

    Click to Return to Search Page VIEW SELECTED LIBRARY MEDIA Name of Media: Cognitive therapy for post-traumatic stress disorder following critical illness and intensive care unit admission Author(s): Hannah Murray, Nick Grey, Jennifer Wild, Emma Warnock-Parkes, Alice Kerr, David M. Clark and Anke Ehlers Publisher or Source: The Cognitive Behavior Therapist Type of Media: Medical Journal 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: Around a quarter of patients treated in intensive care units (ICUs) will develop symptoms of post-traumatic stress disorder (PTSD). Given the dramatic increase in ICU admissions during theCOVID-19 pandemic, clinicians are likely to see a rise in post-ICU PTSD cases in the coming months.Post-ICU PTSD can present various challenges to clinicians, and no clinical guidelines have beenpublished for delivering trauma-focused cognitive behavioural therapy with this population. In this article, we describe how to use cognitive therapy for PTSD (CT-PTSD), a first line treatment for PTSD recommended by the National Institute for Health and Care Excellence. Using clinical case examples, we outline the key techniques involved in CT-PTSD, and describe their application to treating patients with PTSD following 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.

  • Health-related Quality of Life after Acute Lung Injury

    Click to Return to Search Page VIEW SELECTED LIBRARY MEDIA Name of Media: Health-related Quality of Life after Acute Lung Injury Author(s): CRAIG R. WEINERT, CYNTHIA R. GROSS, JAMES R. KANGAS, CARON L. BURY, and WILLIAM A. MARINELLI Publisher or Source: American Journal of Respiratory and Critical Care Medicine 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 Primary Focus of Media: Pre-Use of PICS Designation COVID-19 Related: No Description: Our study objective was to assess health-related quality of life in survivors of acute lung injury (ALI) and to supplement generic and disease-specific questionnaires with findings from a focus group of ALI survivors. Six patients participated in the focus group, which revealed patient concerns with amnesia, depressed mood, avoidance behaviors, and a prolonged recovery period. Using a cross-sectional study design, 24 patients completed a questionnaire 6 to 41 mo after their lung injury. A total of 43% of the patients with ALI met criteria for depression; 43% had self-reported significant functional limitations, although 39% had minimal or no limitations. Significant respiratory and psychologic symptoms were reported in a quarter to a third of patients. There were large decrements in all domains of the SF-36 (a generic health-related quality-of-life instrument) in our sample compared with norms previously established for the general population. In addition, our patients had similar physical difficulties compared with previously studied patients with chronic medical illnesses but had more deficits in the social functioning and mental health domains. We conclude that long after lung injury, survivors have significantly lower health-related quality of life than the general population and are likely to have pulmonary and psychologic symptoms. 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.

  • Terms of Service for Mobile App | Post ICU | PICS

    PostICU, Inc. Terms of Service for Mobile App ​ Terms ​ By accessing our app, PostICU, you are agreeing to be bound by these terms of service, all applicable laws and regulations, and agree that you are responsible for compliance with any applicable local laws. If you do not agree with any of these terms, you are prohibited from using or accessing PostICU. The materials contained in PostICU are protected by applicable copyright and trademark law. Use License Permission is granted to temporarily download one copy of PostICU per device for personal, non-commercial transitory viewing only. This is the grant of a license, not a transfer of title, and under this license, you may not: modify or copy the materials; use the materials for any commercial purpose, or for any public display (commercial or non-commercial); attempt to decompile or reverse engineer any software contained in PostICU; remove any copyright or other proprietary notations from the materials; or transfer the materials to another person or "mirror" the materials on any other server. This license shall automatically terminate if you violate any of these restrictions and may be terminated by PostICU, Inc. at any time. Upon terminating your viewing of these materials or upon the termination of this license, you must destroy any downloaded materials in your possession whether in electronic or printed format. Disclaimer The materials within PostICU are provided on an 'as is' basis. PostICU, Inc. makes no warranties, expressed or implied, and hereby disclaims and negates all other warranties including, without limitation, implied warranties or conditions of merchantability, fitness for a particular purpose, or non-infringement of intellectual property or other violation of rights. Further, PostICU, Inc. does not warrant or make any representations concerning the accuracy, likely results, or reliability of the use of the materials on its website or otherwise relating to such materials or on any sites linked to PostICU. Limitations In no event shall PostICU, Inc. or its suppliers be liable for any damages (including, without limitation, damages for loss of data or profit, or due to business interruption) arising out of the use or inability to use PostICU, even if PostICU, Inc. or a PostICU, Inc. authorized representative has been notified orally or in writing of the possibility of such damage. Because some jurisdictions do not allow limitations on implied warranties, or limitations of liability for consequential or incidental damages, these limitations may not apply to you. Accuracy of materials ​ The materials appearing in PostICU could include technical, typographical, or photographic errors. PostICU, Inc. does not warrant that any of the materials on PostICU are accurate, complete, or current. PostICU, Inc. may make changes to the materials contained in PostICU at any time without notice. However, PostICU, Inc. does not make any commitment to update the materials. Links PostICU, Inc. has not reviewed all of the sites linked to its app and is not responsible for the contents of any such linked site. The inclusion of any link does not imply endorsement by PostICU, Inc. of the site. Use of any such linked website is at the user's own risk. Modifications PostICU, Inc. may revise these terms of service for its app at any time without notice. By using PostICU you are agreeing to be bound by the then current version of these terms of service. Governing Law These terms and conditions are governed by and construed in accordance with the laws of Oregon and you irrevocably submit to the exclusive jurisdiction of the courts in that State or location.

  • Prognosis of cirrhotic patients admitted to intensive care unit: a meta-analysis

    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.

PostICU Library Policy & Compliance Statement

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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