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Imagine being told you have been diagnosed with a life-altering illness and as a result, will need to deliver your baby prematurely, or that your son or daughter was involved in a car crash and has suffered severe head trauma, or your significant other needs open heart surgery after a positive stress test. There is no doubt you and your family will experience feelings of great anxiety, fear, and sadness. Each of these experiences may lead to an intensive care unit (ICU) admission for your loved one. An ICU stay will further exacerbate these overwhelming emotions and leave you emotionally and mentally changed.
According to Davidson, Jones, and Bienvenu (2012), one-third of parents with a child in the ICU have clinically significant symptoms of acute stress disorder. Additionally, 40% of relatives with loved ones who are critically ill suffer from anxiety. Depression, anxiety, and post-traumatic stress disorder (PTSD) are found to be at the highest levels in families of patients in the ICU (Jones, Backman, & Griffiths, 2012).

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High-pitched alarms beep sporadically. A ventilator wheezes. You have an IV line stuck in your arm, a breathing tube down your throat, and a catheter in your urethra. As a patient in a hospital intensive care unit, chances are good that you feel helpless, scared, and confused. Odds are also good, new research shows, that the ordeal could trigger mild to severe depression.

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Mortality rates of critically ill patients have decreased markedly in recent years thanks to advancements in care. Given the improved survival rates of critically ill patients, investigators have broadened their focus from short-term mortality to long-term mortality and morbidities that are often under recognized by intensive care unit (ICU) practitioners. The Society of Critical Care Medicine (SCCM) has defined post–intensive care syndrome (PICS) as a new or worsening decrement in mental, cognitive, or physical health following critical illness that persists beyond the acute hospitalization. Many medication-related risk factors are associated with development of cognitive impairment in critically ill patients, including glucose dysregulation, delirium, and medications. Medications have also been associated with acute neuromuscular weakness following an ICU admission. In the past decade, the increased risk of adverse drug events (ADEs) during transitions of care has become widely known. This column focuses on how medication management strategies in the ICU, after the ICU, and after hospitalization may prevent or help manage PICS

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PLATTSBURGH — There is a gap in care when people leave the ICU and return to their lives.
To help those suffering after an ICU admission, a Post Intensive Care Syndrome (PICS) Support Group was launched at the University of Vermont Health Network, Champlain Valley Physicians Hospital in Plattsburgh.

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PICS/PICS-F overview for caregivers.

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Richmond Agitation-Sedation Scale (RASS) is a medical scale used to measure the agitation or sedation level of a person. It was developed with efforts of different practitioners, represented by physicians, nurses and pharmacists.

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Our objective was to summarize and critically review data on the prevalence of posttraumatic stress disorder (PTSD) in general intensive care unit (ICU) survivors, risk factors for post-ICU PTSD, and the impact of post-ICU PTSD on health-related quality of life (HRQOL).

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This Facilitator’s Guide contains an overview of each video, strategies to create an environment in which the learners are allowed to reflect openly and recognize
good and poor communication, a template for showing the video, suggestions for facilitating debriefing discussions, and additional questions to facilitate conversation on specific elements addressed in each video.

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Jessica, a nurse, is a survivor of post-intensive care syndrome (PICS).
Below, she recounts her experiences in the ICU and after discharge.
As you read her story, think about how you and your peers provide
care to critically ill patients—and how you might be able to prevent
some of the negative effects experienced by ICU patients.

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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.

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Background
Several studies have described improved outcomes for HIV‐infected patients admitted to the intensive care unit (ICU) since the introduction of highly active antiretroviral therapy (HAART). A study was undertaken to examine the outcome from the ICU for HIV‐infected patients and to identify prognostic factors.

Methods
A retrospective study of HIV‐infected adults admitted to a university affiliated hospital ICU between January 1999 and December 2005 was performed. Information was collected on patient demographics, receipt of HAART (no patient began HAART on the ICU), reason for ICU admission and hospital course. Outcomes were survival to ICU discharge and to hospital discharge.

Results
102 patients had 113 admissions to the ICU; HIV infection was newly diagnosed in 31 patients. Survival (first episode ICU discharge and hospital discharge) was 77% and 68%, respectively, compared with 74% and 65% for general medical patients. ICU and hospital survival was 78% and 67% in those receiving HAART, and 75% and 66% in those who were not. In univariate analysis, factors associated with survival were: haemoglobin (OR = 1.25, 95% CI 1.03 to 1.51, for an increase of 1 g/dl), CD4 count (OR = 1.59, 95% CI 0.98 to 2.58, for a 10‐fold increase in cells/µl), APACHE II score (OR = 0.51, 95% CI 0.29 to 0.90, for a 10 unit increase) and mechanical ventilation (OR = 0.29, 95% CI 0.10 to 0.83).

Conclusions
The outcome for HIV‐infected patients admitted to the ICU was good and was comparable to that in general medical patients. More than a quarter of patients had newly diagnosed HIV infection. Patients receiving HAART did not have a better outcome.

Brief description of media:

The goals of the presentation are to help the audience to understand: the types of PICS, what makes up PICS, the "burden of survivorship", and some novel interventions for treatment of PICS.