Brief description of media:

When patients enter the dynamic environment of an intensive care unit (ICU) they are often not only critically ill but are also experiencing a psychological crisis (Hardicre, 2003a). Last week two studies were published that highlight the stressful effects of this experience.

Brief description of media:

The emotional aftermath of critical illness/injury is something that often catches people by surprise but can have a significant impact on daily life. People who have been critically ill/injured often describe difficulty with anxiety, depression, and symptoms of post-traumatic stress disorder such as nightmares, flashbacks, and insomnia.

Brief description of media:

The risk of having PSS is higher among people admitted to an intensive care unit (ICU) and for those who have been in the hospital for extended periods of time. PSS can affect people of any age, but a study from the University of Michigan Health System, published in 2010 the medical journal JAMA, found that older severe sepsis survivors were at higher risk for long-term cognitive impairment and physical problems than others their age who were treated for other illnesses. Their problems ranged from no longer being able to walk to not being able to participate in everyday activities, such as bathing, toileting, or preparing meals. Changes in mental status can range from no longer being able to perform complicated tasks to not being able to remember everyday things.

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:

Post-traumatic stress disorder (PTSD) may develop after exposure to a life-threatening event or serious injury. Symptoms include recurring and intrusive memories, such as flashbacks, avoidance of reminders and persistent symptoms of anxiety or physiological arousal. Many factors are associated with the development of PTSD in intensive care unit (ICU) patients, including increased length of stay, and greater levels and longer duration of sedation. Patient-related factors associated with a higher risk of PTSD include younger age, female gender,previous psychological problems and recall of delusional memories from ICU. In contrast, the formation of even fragmented factual memories may reduce the risk of PTSD. Optimum, analgesia-based sedation may help patients to form factual memories of ICU, so possibly reducing the risk of PTSD. Patient diaries, written by health professionals and family members and close friends, may also support patients in coming to terms with traumatic, delusional memories, and so reduce their emotional and psychological symptoms. Following ICU discharge, validated screening tools such as ICU Memory and Post-traumatic Stress Syndrome 14-Questions Inventory can be used as part of routine follow-up to identify patients who may need referral for more specialist assessment of possible PTSD symptoms.

Brief description of media:

Many patients who are discharged from the Intensive Care Unit (ICU) frequently suffer health problems long after they've left the hospital. The patient and their loved ones are often puzzled as to why, having survived a critical illness, that the former ICU patient is unable to work, enjoy activities, gain weight, and/or regain happiness after leaving the hospital. In researching this topic, I was alarmed at the number of individuals who are plagued by a profound range of serious mental health issues coupled with prolonged physical weakness.

The purpose of this piece is to bring attention to the widespread incidence of post-ICU depression and mental health and to encourage education and networking of professionals interested in assisting post-ICU patients and their caregivers. Hopefully, information contained in the article will provide caregivers and loved ones of former ICU patients with practical suggestions on how to initiate a successful dialog with a variety of health care professionals and mental health providers to ensure that the post-ICU care received results in the best possible outcome.

Brief description of media:

Patients may suffer extreme psychological reactions in intensive care units (ICU), and post-traumatic stress disorder (PTSD) after leaving hospital. Previous systematic reviews of studies up to 2007 found that the true prevalence of and consistent risk factors for PTSD after ICU were not established, due to methodological shortcomings of studies. Therefore we aimed to conduct a systematic review of observational studies of post-ICU PTSD from 2008-2012, and to compare them to 1997-2007 studies, with regard to quality, prevalence estimates and risk factors.

Brief description of media:

3 months after discharge from the Intensive Care Unit (ICU) and determine the impact of different components of PICS-P upon caregiver burden.
Design: A prospective observational study was conducted over 26 months (January 2013---February 2015).
Setting: Medical-surgical ICU and follow-up consultation in Portugal.
Patients or participants: Patients discharged after a minimum of 2 days in the ICU. Caregiver inclusion criteria: not paid, written and spoken Portuguese, and agreement to participate in the study.
Main variables of interest: In ICU: Patient gender, age, severity of illness (SAPS II) and length of ICU stay. At 3 months caregiver burden, physical (reduced mobility, weakness acquired in the ICU) and psychological components of PICS (anxiety, depression, post-traumatic stress disorder).
Results: A total of 168 caregivers completed the survey (response rate of 69%). A low degree of overburden was reported by 34.5% of caregivers, while 15.5% showed moderate to high levels of overburden.
Patient anxiety and depression 3 months after ICU discharge significantly influenced the presence of caregiver burden (p = 0.030 vs p = 0.008).
When physical components of PICS-P were evaluated, no influence on caregiver burden was observed. Patient demographics, severity of illness and length of stay also failed to influence caregiver burden.
Conclusions: The presence of psychological components of PICS-P 3 months after ICU seems to have a negative impact upon caregiver burden. On the other hand, physical problems showed no important impact upon caregiver overburden.

Brief description of media:

Survival of critically unwell patients has improved in the last decade due to advances in critical care medicine. Some of these survivors develop cognitive, psychiatric and /or physical disability after treatment in intensive care unit (ICU), which is now recognized as post intensive care syndrome (PICS). Given the limited awareness about PICS in the medical faculty this aspect is often overlooked which may lead to reduced quality of life and cause a lot of suffering of these patients and their families. Efforts should be directed towards preventing PICS by minimizing sedation and early mobilization during ICU.All critical care survivors should be evaluated for PICS and those having signs and symptoms of it should be managed by a multidisciplinary team which includes critical care physician, neuro-psychiatrist, physiotherapist and respiratory therapist,with the use of pharmacological and non-apharmacological interventions. This can be achieved through an organizational change and improvement, knowing the high rate of incidence of PICS and its adverse effects on the survivor’s life and daily activities and its effect on the survivor’s family. Key words: cognition, critical illness, intensive care, syndrome

Brief description of media:

Researchers are still trying to understand everything that Ronan and other COVID-19 patients need to let them move on with their lives after being in the ICU. Mysteries abound, but the groundwork laid by Sevin, Needham, Weinhouse, and others has provided a solid foundation on which to build.

Brief description of media:

Critical care services are atypical in the wide heterogeneity of their patients. This is in part a reflection of the way in which these services have evolved. The progress of intensive care in the UK has been described as ‘haphazard’, consisting of ‘largely unplanned and unevaluated’ developments that occurred in reaction to changes in surgical and medical practice. There has been debate about the configuration of critical care services, fuelled by a perception that there are not enough beds in some parts of the country and that existing beds are not in the right places. During the late 1990s, the NHS Executive established a National Expert Group to review adult critical care services in the UK and to produce a national Framework for future organisation and care delivery. As a result, in May 2000 a critical care modernisation plan was announced.

Brief description of media:

Over 6 million patients become critically ill each year. Of these, an increasing number will survive due to advances in critical care. However, this survival is not without cost. As the long term effects of critical illness become known, the need to design and implement effective interventions to rescue critical illness survivors from incomplete recovery has become a pressing priority for many clinicians. However, evidence based guidelines for intensive care unit (ICU) follow up and recovery remain elusive. In 2012, we started seeing patients in an outpatient team clinic designed to screen for and treat Post Intensive Care Syndrome (PICS), with the goal of promoting recovery for the sickest patients who survive the ICU. This effort was inspired by a patient in the Vanderbilt Medical ICU, and was undertaken as a pragmatic clinical intervention in an attempt to address the multifaceted yet ICU-specific problems emerging in the literature and in practice.