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Long-term follow-up of randomized prospective trials of treatments in the intensive care unit may allow us to attain some understanding of the causes of post-intensive care syndrome. This in turn may allow us to produce better long-term outcomes among survivors of critical illness.

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Long-term follow-up of randomized prospective trials of treatments in the intensive care unit may allow us to attain some understanding of the causes of post intensive care syndrome. This in turn may allow us to produce better long-term outcomes among survivors of critical illness.

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CAESAR study may assist clinicians and researchers in developing better strategies to assist the relatives of dying ICU patients. This large, prospective study evaluated the perspectives of relatives of dying patients in the ICU. Extensive work was done to establish a simple tool with which to assess the experience of relatives of the dying, which was then correlated with subsequent psychological distress.

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Increasing numbers of survivors of critical illness are at risk for physical, cognitive, and/or mental health impairments that may persist for months or years after hospital discharge. The post-intensive care syndrome framework encompassing these multidimensional morbidities was developed at the 2010 Society of Critical Care Medicine conference on improving long-term outcomes after critical illness for survivors and their families.

Brief description of media:

Increasing numbers of survivors of critical illness are at risk for physical, cognitive, and/or mental health impairments that may persist for months or years after hospital discharge. The post-intensive care syndrome framework encompassing these multidimensional morbidities was developed at the 2010 Society of Critical Care Medicine conference on improving long-term outcomes after critical illness for survivors and their families.

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This midrange theory is derived from Sr. Calista Roy’s adaptation model and Professor Weick’s business model of sensemaking. In his sensemaking model Weick describes that people define themselves through actions taken in crisis. Also, leaders shape the vision of an organization’s well-being through messaging. In facilitated sensemaking, the nurse helps the family to cue sort, and interpret the meaning of those cues in the environment. The nurse provides the family purpose by facilitating individualized engagement in care and praising them for their efforts. Even in the worst of outcomes they can look back and say they did everything possible to help the team. Simple activities provide focus and modulate the limbic system response to stress which may mediate the development of stress disorders.

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Of all his years, 2020 was exceptionally challenging for Vietnam veteran Matthew Thomas. After the 75-year-old Aurora resident tested positive for Covid-19 in mid-May, doctors had to intubate him for 33 days, so he didn’t go into respiratory failure. While Thomas survived, his 33-year-old son, diagnosed with Covid-19 shortly before his father was hospitalized, passed away.

Thomas also faced widespread effects from Covid-19, stemming from the time spent intubated and in intensive care. “The byproduct of the disease is that my muscles went to sleep,” says Thomas, who says his muscles became so weak that he could not use his arms and legs.

“I couldn’t do anything. I couldn’t even stand up,” he says.

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Bronchiolitis obliterans syndrome (BOS) is a form of chronic graft vs. host disease (cGVHD) and a highly morbid pulmonary complication after allogeneic hematopoietic stem cell transplantation (HSCT). We assessed the prevalence and risk factors for BOS and cGVHD in a cohort of HSCT recipients, including those who received reduced intensity conditioning (RIC) HSCT. Between January 1, 2000 and June 30, 2010, all patients who underwent allogeneic HSCT at our institution (n 5 1854) were retrospectively screened for the development of BOS by PFT criteria.

We matched the BOS cases with two groups of control patients: (1) patients who had concurrent cGVHD without BOS and (2) those who developed neither cGVHD nor BOS. Comparisons between BOS patients and controls were conducted using t-test or Fisher’s exact tests. Multivariate regression analysis was performed to examine factors associated with BOS diagnosis. All statistical analyses were performed using SAS 9.2. We identified 89 patients (4.8%) meeting diagnostic criteria for BOS at a median time of 491 days (range: 48–2067) after HSCT. Eighty-six (97%) of our BOS cohort had extra-pulmonary cGVHD. In multivariate analysis compared to patients without cGVHD, patients who received busulfan-based conditioning, had unrelated donors, and had female donors were significantly more likely to develop BOS, while ATG administration was associated with a lower risk of BOS. Our novel results suggest that busulfan conditioning, even in RIC transplantation, could be an important risk factor for BOS and cGVHD.
Am. J. Hematol. 89:404–409, 2014. VC 2013 Wiley Periodicals, Inc.

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1. Identify symptoms and risk factors for post-intensive care syndrome-families (PICS-F).
2. Describe techniques for preventing PICS-F.
3. Discuss management of PICS-F.

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Preventing, assessing, and treating trauma suffered by families of a hospitalized loved one.

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Aim
To describe published literature on the needs and experiences of family members of adults admitted to intensive care and interventions to improve family satisfaction and psychological well‐being and health.
Design
Scoping review.
Methods
Several selective databases were searched. English‐language articles were retrieved, and data extracted on study design, sample size, sample characteristics and outcomes measured.
Results
From 469 references, 43 studies were identified for inclusion. Four key themes were identified: (a) Different perspectives on meeting family needs; (b) Family satisfaction with care in intensive care; (c) Factors having an impact on family health and well‐being and their capacity to cope; and (d) Psychosocial interventions. Unmet informational and assurance needs have an impact on family satisfaction and mental health. Structured written and oral information shows some effect in improving satisfaction and reducing psychological burden. Future research might include family in the design of interventions, provide details of the implementation process and have clearly identified outcomes.

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This slides present information regarding the updated Guidelines for family centered care in 4 sections: First, the guideline development process focusing on changes and novel approaches taken. Next, the recommendations, sorted not in the order you would find them in the manuscript, but instead by which recommendations are retained from the 2007 Guidelines, and then new recommendations. Tools that were simultaneously developed by a combined team of guidelines writing members and members of a task force from the SCCM Patient/Education Committee. Finally, topics for future research in family centered care: What we know we do not know.