Brief description of media:

The study objective was to obtain consensus on physical therapy (PT) in the rehabilitation of critical illness survivors after hospital discharge. Research questions were: what are PT goals, what are recommended measurement tools, and what constitutes an optimal PT intervention for survivors of critical illness?

Brief description of media:

Every year, about 6 million people are admitted to intensive care units with a life-threatening illness. As medical technology advances, more people survive conditions that once would have been fatal. However, about half of these ICU survivors develop some form of cognitive, psychosocial, and physical deficits in a condition known as post-intensive care syndrome, or PICS.

Brief description of media:

Every year, about 6 million people are admitted to intensive care units with a life-threatening illness. As medical technology advances, more people survive conditions that once would have been fatal. However, about half of these ICU survivors develop some form of cognitive, psycho-social and physical deficits in a condition known as post-intensive care syndrome, or PICS.

Brief description of media:

A steadily increasing number of patients survive their stay in the Intensive Care Unit (ICU), and a significant percentage become chronic cases. Patient post-intensive care syndrome (PICS-P) is a recently described condition that affects an important number of patients (30---50%). It encompasses the physical (mainly respiratory and neuromuscular), cognitive (memory and attention) and psychological sequelae (depression, anxiety, stress and/or post-traumatic stress syndrome) at discharge from the ICU, and which have a negative impact upon patient quality of life. This syndrome also affects the family of the patient(PICS-F). In effect, the patient relatives constitute a vulnerable and often forgotten group of individuals that nevertheless suffer negative physical, psychological and social effects that worsen their quality of life.

Brief description of media:

A steadily increasing number of patients survive their stay in the Intensive Care Unit (ICU), and a significant percentage become chronic cases. Patient post-intensive care syndrome (PICS-P) is a recently described condition that affects an important number of patients (30---50%). It encompasses the physical (mainly respiratory and neuromuscular), cognitive (memory and attention) and psychological sequelae (depression, anxiety, stress and/or post-traumatic stress syndrome) at discharge from the ICU, and which have a negative impact upon patient quality of life.

Brief description of media:

Whether intensivists should be present in ICUs around the clock is currently a matter of considerable controversy. This controversy is intertwined with a debate about the comparative performance of open versus closed ICUs. A complicating factor is the existence of considerable differences in ICU organization across countries (1). In the open format, no intensivists continue to care for the patients they admit to the ICU, with advice from consulting intensivists. This is the most common format in the United States (1). In the closed format, all care is given by intensivists, which occurs for up to 75% of ICU patients in Western Europe (2, 3). Patients managed in closed ICUs are the sickest ICU patients (1).

Brief description of media:

Two months after leaving the intensive care unit, Rob Rainer returned to his law practice in Revere, eager to resume his old life after surviving a severe lung infection that tethered him to a breathing machine for a month. But as he sat down at his desk, the former hard-driving multitasker found he couldn’t stay on track with even one task. Phone conversations left him overwhelmed. He was baffled by a computer program he himself had developed.
Today, five years later, Rainer’s life is very different — his law practice shuttered, his two houses sold. At 58, he lives modestly with his wife in a small condo in Hudson, N.H. While the novel coronavirus didn’t exist in 2015, today thousands of COVID-19 patients in the United States are enduring the same experience that Rainer did, lying in a medication-induced coma as a ventilator pushes air into their weakened lungs for days or weeks on end. And like Rainer, many will never be the same.

Brief description of media:

People usually associate post-traumatic stress disorder with those who survive military combat, major catastrophes, or assaults. But critically ill patients who survive an intensive care unit stay are at equally high risk for PTSD.

Brief description of media:

The case for adopting the 3M TegadermCHGIV securement dressing for central venous and arterial catheter insertion sites is supported by the evidence. This technology allows observation, and provides antiseptic coverage, of the catheter insertion site. It reduces catheter-related bloodstream infections and local site infections compared with semipermeable transparent (standard) dressings. It can be used with existing care bundles.

The 3M TegadermCHGIV securement dressing should be considered for use in critically ill adults who need a central venous or arterial catheter in intensive care or high dependency units. The estimated cost saving from using a 3M Tegaderm CHGIV securement dressing (TegadermCHG) instead of a standard transparent semipermeable dressing is £93 per patient. This estimate is based on a baseline catheter-related bloodstream infection rate of 1.48 per 1,000catheter days. Tegaderm CHG is estimated to be cost neutral when the baseline catheter-related bloodstream infection rate is 0.18 per 1,000catheter days, and cost incurring when the baseline rate falls below that figure. [2019 – see section[2019 – see section5.25] 5.25]

Brief description of media:

The case for adopting the 3M TegadermCHGIV securement dressing for central venous and arterial catheter insertion sites is supported by the evidence. This technology allows observation, and provides antiseptic coverage, of the catheter insertion site. It reduces catheter-related bloodstream infections and local site infections compared with semipermeable transparent (standard) dressings. It can be used with existing care bundles.

The 3M TegadermCHGIV securement dressing should be considered for use in critically ill adults who need a central venous or arterial catheter in intensive care or high dependency units. The estimated cost saving from using a 3M TegadermCHGIV securement dressing (TegadermCHG) instead of a standard transparent semipermeable dressing is £93 per patient. This estimate is based on a baseline catheter-related bloodstream infection rate of 1.48 per 1,000catheter days. TegadermCHG is estimated to be cost neutral when the baseline catheter-related bloodstream infection rate is 0.18 per 1,000catheter days, and cost incurring when the baseline rate falls below that figure.

Brief description of media:

This article demonstrates the principles of treatment on Respiratory Complications in Poliomyelitis patients through several real cases that patients had been improved by measures usually carried out by the anesthetist during his daily work in the operating room.

Brief description of media:

The objective of this study was to refine the APACHE (Acute Physiology, Age, Chronic Health Evaluation) methodology in order to predict hospital mortality risk more accurately 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).