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Main results: Interviews were obtained for family members of 284 (62%) of the 459 eligible patients. Post-traumatic stress symptoms consistent with a moderate to major risk of PTSD were found in 94 (33.1%) family members. Higher rates were noted among family members who felt information was incomplete in the ICU (48.4%), who shared in decision making (47.8%), whose relative died in the ICU (50%), whose relative died after end-of-life decisions (60%), and who shared in end-of-life decisions (81.8%). Severe post-traumatic stress reaction was associated with increased rates of anxiety and depression and decreased quality of life. Conclusion: Post-traumatic stress reaction consistent with a high risk of PTSD is common in family members of ICU patients and is the rule among those who share in end-of-life decisions.

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American Association of Critical-Care Nurses, compromised transitional care for ICU patients may result in complications, including adverse events,4–6 readmission to the ICU,7,8 and increased rates of mortality.5,7,9 The knowledge gained by studying ICU patients, who experience a number of transitions, will provide insight and understanding of the process these patients undergo and facilitate improved clinical practices that may be applicable to other groups of patients. In this article, we review current literature on transitional care for ICU patients, with a focus on contemporary challenges, problematic clinical practices, and future research directions.

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Post-intensive care syndrome, also known as PICS, is a group of symptoms that may occur in people after discharge from an Intensive Care Unit (ICU). PICS can affect daily living, slow thinking, or cause difficulties with processing thoughts.

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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.

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Despite caring for the sickest patients in the hospital, critical care teams have seen significant improvements in rates for mortality, sepsis and a host of other measures. For example, mortality among patients with acute respiratory distress syndrome has decreased from about 40 percent to 28 percent, and septic shock mortality has decreased from 33 percent to 18 percent.

However, despite these impressive reductions in mortality, ICU care frequently leaves patients feeling weak, confused, possibly depressed and with PTSD, and with a long road to recovery. During the past decade, more attention has been directed to recognizing and preventing symptoms that have come to be recognized as “post-intensive care unit syndrome.”

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Did you know, you don’t have to be “living” dangerously, to get PTSD ? A stint in an ICU, can bring on the condition, impeding your recovery long term

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This article contains key information on assisting family members survive when a loved one is in the intensive care unit. Communication, decision making, multi-disciplinary meetings, pain/comfort, and sleep are discussed. Hopefully, knowing this information will help you and your loved one have a positive experience and survive your time in the ICU.

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Two months after leaving the intensive care unit, Rob Rainer returned to his law practice in Revere, eager to resume his old life after surviving a severe lung infection that tethered him to a breathing machine for a month.
But as he sat down at his desk, the former hard-driving multitasker found he couldn’t stay on track with even one task. Phone conversations left him overwhelmed. He was baffled by a computer program he himself had developed.
Today, five years later, Rainer’s life is very different — his law practice shuttered, his two houses sold. At 58, he lives modestly with his wife in a small condo in Hudson, N.H.
While the novel coronavirus didn’t exist in 2015, today thousands of COVID-19 patients in the United States are enduring the same experience that Rainer did, lying in a medication-induced coma as a ventilator pushes air into their weakened lungs for days or weeks on end. And like Rainer, many will never be the same.

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Pain, Agitation, and Delirium Management Orderset

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For post-ICU recovery clinics, the opportunities that exist for telehealth and mobile
technologies to help extend care delivery, reduce costs, improve the quality of care, and the patient experience in the post discharge period are significant. The demand for intensive care is projected to rise because of an aging population with complex comorbidities and the expanded use of advanced healthcare treatments, and as a result, the number of ICU survivors will rise . Survivors of critical illness require early identification of symptoms and early interventions to decrease symptom burden and enhance their quality of life. Redesign of post-ICU care management and post acute care delivery systems is needed to engage ICU survivors in self-care, monitor for early signs of deteriorating health, intervene early, and reduce costs. As new value-based payment models for medical services increasingly take hold, financial incentives will also need to align with rehabilitation-oriented services in this population with greater focus on post-ICU care.

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Posthospital care of ICU survivors remains both a challenge and an opportunity. The mandate to optimize critical illness recovery with tailored survivorship programs seems clear. Additional research and clinical experience are needed to further delineate the needs of ICU survivors and develop effective interventions to mitigate the effects of PICS, with the goal of maximizing recovery after critical illness.

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This is a referral form that includes information about PICS and PICS-F.