Brief description of media:

Define the characteristics of Post-Intensive
Care Syndrome (PICS).
Identify the incidence, prevalence and risk
factors of PICS.
Identify strategies for preventing and
managing PICS.

Brief description of media:

Significant improvements have been made with regard to mortality in patients with sepsis and critical illness over the last decade. However, this success is mitigated by the fact that 60-80 % of critically ill patients will become delirious during their hospital stay1, 50-70% will suffer cognitive impairment after discharge,2 and 60-80% will have physical disability due to ICU acquired weakness3. Furthermore, survivors of critical illness are five times more likely to develop depression4 after discharge and up to 25% will experience symptoms of post-traumatic stress disorder (PTSD)5.

Brief description of media:

Immobility in the intensive care unit (ICU) is associated with neuromuscular weakness, post–intensive care syndrome, functional limitations, and high costs. Early mobility–based rehabilitation in the ICU is feasible and safe. Mobility-based rehabilitation varied widely across 5 ICUs in 1 health care system, suggesting a need for continuous training and evaluation to maintain a strong mobility-based rehabilitation program. Early mobility–based rehabilitation shortens ICU and hospital stays, reduces delirium, and increases muscle strength and the ability to ambulate. Long-term effects include increased ability for self-care, faster return to independent functioning, improved physical function, and reduced hospital readmission and death. Factors that influence early mobility–based rehabilitation include having an interdisciplinary team; strong unit leadership; access to physical, occupational, and respiratory therapists; a culture focused on patient safety and quality improvement; a champion of early mobility; and a focus on measuring performance and outcomes.

Brief description of media:

The aim in this literature review is to describe the definitions, denominations, clinical signs and symptoms, explanations, causative factors and interrelationships of the intensive care syndrome discussed since 1950. It was found that there is no agreement about which symptoms should be included in the syndrome, when the syndrome may appear and how many patients may be affected. Furthermore, it is unclear what causes the development of the syndrome; most authors conclude that there are many reasons for it. The syndrome has generally been examined by using a medical or psychological approach, but during the last few years it has also been described and analysed from a nursing care perspective.

Brief description of media:

The m-CCRP aims to improve the recovery of acute respiratory failure survivors utilizing a mobile care coordinator. The NIH-funded randomized controlled trial will evaluate the success of m-CCRP in improving the health-related quality of life as well as the cognitive, physical and psychological functioning of ARF survivors. Dr. Khan and colleagues will also determine if m-CCRP reduces future health care utilization by ICU survivors.

Brief description of media:

Patients who have prolonged stays, getting intubated and sedated, may experience severe hallucinations, putting them at risk of PTSD for years to come, studies show.

Brief description of media:

For years it has been known that many patients who survive critical illness do not return to their original state of health, resulting in long-term consequences of critical illness.1Weakness acquired in the intensive care unit (ICU) is a physical consequence occurring in 25% to 80% of patients who receive mechanical ventilation for more than 4 days and in 50% to 75% of patients with sepsis. Nearly all patients affected with ICU-acquired weakness have symptoms that persist years later.1,2 Issues with cognitive function occur in 30% to 80% of ICU survivors and include memory, planning, problem-solving, visual-spatial, and processing problems.1,3 Cognitive consequences may improve during the months after discharge. However, 25% of patients with adult respiratory distress syndrome (ARDS) have long-term persistent cognitive impairment 6 years after discharge.

Brief description of media:

John Hopkins Medicine: Results of a multi-institutional national study of nearly 700 people who survived life-threatening illness with a stay in an intensive care unit suggest that a substantial majority of them are at high risk for persistent depression, anxiety and post-traumatic stress disorder -- especially if they are female, young and unemployed.

Brief description of media:

Post-sepsis syndrome is a condition that affects up to 50% of sepsis survivors.

Brief description of media:

PICS isn’t just an ICU issue. As a nurse, you can make a positive impact in various settings throughout the continuum of care. The strongest evidence to date supports that, for families of ICU patients, communication and information help minimize adverse outcomes. What caregivers say, how they say it, how soon, how often, and how it’s perceived by patients and families are factors that have been studied and seem to affect long-term consequences of critical illness. Early mobility is known to minimize both physical problems and delirium in ICU patients.

Brief description of media:

Nearly one-quarter of intensive care unit survivors have post-traumatic stress disorder; diaries could be successful prevention tool. Through a systematic literature review, the research team looked at 40 studies of 36 unique patient cohorts with a total of more than 3,000 patients who survived a critical illness and ICU stay. The researchers excluded patients who had suffered a trauma, such as a car crash, or brain injury, because those patients’ cognitive and psychological outcomes can be affected by the injury itself, rather than the critical illness/ICU stay. They found that the prevalence of PTSD in the studies ranged from 10 to 60 percent.

Brief description of media:

John Hopkins Medicine: The researchers found that 66 of the 186 patients (35 percent) had clinically significant symptoms of PTSD, with the greatest apparent onset occurring by the initial, three-month follow-up visit. Sixty-two percent of the survivors who developed PTSD still had symptoms at their two-year visit. Half of this same group was taking psychiatric medications, and 40 percent had seen a psychiatrist in the two years since being hospitalized with ALI.