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This booklet contains advice and information about intensive care. It tells you how critical illness may be treated and what recovery may be like. Not every patient will experience all of these things, but they are more likely to if they have been in intensive care for more than a few days. Most of this booklet is written for patients but there is a section specifically for relatives and visitors. By reading this booklet, relatives will learn what a patientʼs recovery may involve and it will give them the answers to some of the questions they may have.

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Post-traumatic stress disorder, a form of anxiety disorder common among war veterans, was also frequently seen among intensive care patients put on a ventilator, a new study shows.

Some patients showed significant effects of the condition, also known as PTSD, up to two years later.

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Background
Illnesses that necessitate intensive care can impair cognitive function severely over the long term, leaving patients less able to cope with the demands of everyday living and markedly lowering their quality of life. There has not yet been any comprehensive study of the cognitive sequelae of critical illness among non-surgical patients treated in intensive care. The purpose of this review is to present the available study findings on cognitive deficits in such patients, with particular attention to prevalence, types of deficit, clinical course, risk factors, prevention, and treatment.
Methods
This review is based on pertinent publications retrieved by a selective search in MEDLINE.
Results
The literature search yielded 3360 hits, among which there were 14 studies that met our inclusion criteria. 17–78% of patients had cognitive deficits after discharge from the intensive care unit; most had never had a cognitive deficit before. Cognitive impairment often persisted for up to several years after discharge (0.5 to 9 years) and tended to improve over time. The only definite risk factor is delirium.
Conclusion
Cognitive dysfunction is a common sequela of the treatment of non-surgical patients in intensive care units. It is a serious problem for the affected persons and an increasingly important socio-economic problem as well. The effective management of delirium is very important. General conclusions are hard to draw from the available data because of heterogeneous study designs, varying methods of measurement, and differences among patient cohorts. Further studies are needed so that study designs and clinical testing procedures can be standardized and effective measures for prevention and treatment can be identified.

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At least one-third of ICU patients and their families experience PICS or PICS-F. Incidence is at least 50% among patients who’ve had sepsis or acute respiratory distress syndrome or were on a mechanical ventilator for more than 5 days. At least half of PICS patients still need some form of care 1 year after hospital discharge. The past decade has seen a tremendous increase in our understanding of the long-term effects of critical illness on patients and their families. As our PICS knowledge base continues to expand, the challenge is to inform healthcare providers who care for critically ill patients during and after their hospital stay of the potential consequences of ICU admission.

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The emotional trauma of a near-death experience causes ongoing emotional and physical symptoms in one-third of ICU patients.

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This article is to evaluate the association between length of ICU stay and 1-year mortality for elderly patients who survived to hospital discharge in the United States.

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Survivors of intensive care are known to be at increased risk of developing longer-term psychopathology issues. We present a large UK multi centre study assessing the anxiety, depression and post-traumatic stress disorder (PTSD) caseness in the first year following discharge from an intensive care unit (ICU).

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Post-ICU clinics may facilitate the care of survivors of critical illness, but there is a paucity of data describing post-ICU clinic implementation. We sought to describe implementation of our ICU recovery clinic, including an assessment of barriers and facilitators to clinic attendance.

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Health professionals have been aware of the incidence of post-intensive care syndrome (PICS) for some time. However, there has not been a clear or definitive way of administering treatment or nursing care to help patients suffering from PICS in their recovery. This paper suggests some ideas for the care of patients from the nursing point of view.

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Focused research over more than a decade by Meredith Mealer, Ph.D., RN and others has shown that Post-traumatic Stress Disorder (PTSD) is as prevalent among nurses working in ICU as in war veterans – but also that greater resilience protects against burnout (BOS) and PTSD. Resilience is being able to adapt effectively to major stress, and it can be learned. This means that you can start developing your resilience now to strengthen your psychological make-up for your future career in nursing.

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-pharmacological 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

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As more patients are surviving intensive care, mental health concerns in survivors have become a research priority. Among these, post-traumatic stress disorder (PTSD) can have an important impact on the quality of life of critical care survivors. However, data on its burden are conflicting. Therefore, this systematic review and meta-analysis aimed to evaluate the prevalence of PTSD symptoms in adult critical care patients after intensive care unit (ICU) discharge.