Brief description of media:

Objectives:
• Review historical perspectives of “Family” in the ICU.
• Examine the concept of “Family” presence in the ICU.
• Identify strategies to create “Family” engagement.
• Identify strategies to create “Family” empowerment.

Brief description of media:

Dr. Netzer was trained at the great bastion of intensive care medicine, the University of Pennsylvania, where he also earned a master’s degree in clinical epidemiology. Since joining the University of Maryland Pulmonary and Critical Care Medicine department he has proven to be one the greatest minds the ICU has to offer, earning him the title: Wiki-Netzer. His passion for knowledge led to his appointment as the Director of Clinical Research and has yielded a tremendous breadth of publications. Today he focuses on his true passion: how to assist family members care for their loved ones both in the ICU and in the post-ICU setting. Trust me, this is a topic that is often overlooked and one that can truly mean life or death for your patients! You cannot miss it!!

Brief description of media:

Most people know that resuscitation efforts aren’t always successful. Armed with this knowledge, family presence during resuscitation (FPDR) can be a comfort to patients who are fearful of dying alone without the support and advocacy of their loved ones.

Brief description of media:

Bedside rounds have evolved concurrently with hospitalist medicine and patient-centered care. Family-centered rounds are the foundation of effective communication in the in-patient pediatric setting. Participant perspectives (family members, patients, nurses, faculty, and trainees) on family-centered rounds differ and goals may not always align. Further, the practical components of how rounds are conducted varies and have continued opportunities for improvement. This article summarizes the most recent experience with rounds in an attempt to identify unified and effective strategies moving forward.

Brief description of media:

Factors that heighten the risk of developing PICS-F include patient and family characteristics, as well as the critical care unit’s environmental characteristics. (See Knowing the risk factors.) The characteristics most amenable to nurses’ preventive actions are those in the critical care environment and those related to family’s needs.

Brief description of media:

You didn’t die. You battled COVID-19 in intensive care for more than a week. You were on a ventilator but pulled through. Now you are disabled. This will happen to a significant number of people who discharge home after fighting COVID-19. It is typical of the course that post-intensive care syndrome (PICS) takes by creating or worsening physical impairment as well as causing cognitive and psychological impairment among patients who have been critically ill. Neuromuscular weakness is the most common form of physical impairment that individuals acquired during a stay in the ICU, with more than 25% having poor mobility, recurrent falls, or quadri or tetra paresis. Physical symptoms often resolve within 12 months after discharge from an acute care setting. However, research shows that ICU-acquired weakness can last as long as 24 months.

Brief description of media:

To describe the duration of fever, fever management, and outcomes among intensive care patients with fever and known or suspected infection. Prospective observational trial in three tertiary intensive care units over 6 weeks in 2010.

Adult patients were screened for eligibility and inclusion if they had a fever of ≥38.0°C and known or suspected infection being treated with antimicrobials; those with neurological injury or elective surgery within 72 hours were excluded. Mean and peak daily temperatures were recorded, and the use of antipyretics and other cooling measures were recorded over the first 7 days. Mortality, ICU-free survival, ventilator-free survival, and renal replacement therapy-free survival were determined at Day 28. 51/565 patients (9.0%) were included. The mean daily peak temperature and the proportion of patients with a documented temperature of ≥38.0°C decreased over the first 3 days after first documented fever. Thereafter, the proportion of patients who had daily peak temperatures ≥38.0°C remained about 20%. Paracetamol was administered to 58%-70% of patients per day. Physical cooling was used at least once for 12% of patients. Mean ICU-free survival to Day 28 in eligible patients was 16.0 (SD, 9.2) days. The mortality rate of eligible patients was more than double that of ineligible patients (8/51 [16%] v 36/514 [7%]; P = 0.05).

We have described the typical time course of fever in an easily identified cohort of patients with known or suspected infection and have determined that these patients have significant morbidity and mortality. This information is vital to the design of interventional studies for the treatment of fever in ICU.

Brief description of media:

This NICE Pathway covers the assessment and early management of fever with no obvious cause in children under 5. It aims to improve clinical assessment and help healthcare professionals diagnose serious illness among young children who present with fever in primary and secondary care. These recommendations should be followed until a clinical diagnosis of the underlying condition has been made. The child should then be treated according to national or local guidance for that condition.

Brief description of media:

The Coronavirus (COVID-19) Pandemic has put a strain on NHS critical care services. Whilst recovering from the acute phase of the pandemic, we need to think of the aftermath and seek solutions to provide effective recovery and rehabilitation services for affected patients and their families. This is a unique opportunity to elevate public understanding of the impact of critical illness on outcomes and recovery.

Brief description of media:

Cost considerations may influence therapeutic reasoning and decisions in the intensive care unit (ICU). To date only very few data illuminating the association of costs and consequences (i.e. outcomes) of critical care services are available. In this study, the long-term outcome, health-related quality of life (HRQL), and ICU and hospital costs of medical ICU patients were assessed.

Brief description of media:

The intensive care unit (ICU) stay has been linked with a number of physical and psychological sequelae, known collectively as post‐intensive care syndrome (PICS). Specific ICU follow‐up services are relatively recent developments in health systems and may have the potential to address PICS through targeting unmet health needs arising from the experience of the ICU stay. There is currently no single accepted model of follow‐up service and current aftercare programs encompass a variety of interventions and materials. There is uncertain evidence about whether follow‐up services effectively address PICS, and this review assesses this.

Brief description of media:

The number of Americans hospitalized with the virus is increasing again, reaching 41,000 late last week, many with a circle of loved ones holding vigil in their minds, even if they can’t sit at the bedside. A decade ago, critical care clinicians coined the term post-intensive care syndrome, or PICS. It describes the muscle weakness, cognitive changes, anxiety, and other physical and mental symptoms that some ICU patients cope with after leaving the hospital. Those complications are fallout from the medications, immobility, and other possible components of being critically ill. Now they worry that some family members of critically ill COVID patients may develop a related syndrome, PICS-Family.