Brief description of media:

PICS/PICS-F overview for caregivers.

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.

Brief description of media:

These slides help the medical student understand the types of PICS, what makes up PICS, the “burden of survivorship” and some novel interventions for the treatment of PICS.

Brief description of media:

These slides help the medical student understand the types of PICS, what makes up PICS, the “burden of survivorship” and some novel interventions for the treatment of PICS.

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:

Background

The sequelae of sepsis were once thought to be independent of sepsis itself and assumed to be either comorbid to sick patients or complications of critical illness. Recent studies have reported consistent patterns of functional disabilities in sepsis survivors that can last from months to years after symptoms of active sepsis had resolved.
Body

Post-sepsis syndrome is an emerging pathological entity that has garnered significant interest amongst clinicians and researchers over the last two decades. It is marked by a significantly increased risk of death and a poor health-related quality of life associated with a constellation of long-term effects that persist following the patient’s bout with sepsis. These include neurocognitive impairment, functional disability, psychological deficits, and worsening medical conditions.
Conclusion

This “post-sepsis syndrome” has been the subject of active preclinical and clinical research providing new mechanistic insights and approaches linked to survivor well-being. Here we review important aspects of these research efforts and goals of care for patients who survive sepsis.

Brief description of media:

Post-traumatic stress disorder (PTSD) can occur after someone experiences a traumatic event. The actual event can be short-lived, such as witnessing an accident or being a victim of a crime, or it can be long-term, like living in an abusive situation or being in a war zone. Not everyone who experiences such events develops PTSD and researchers don’t know why some people do while others don’t.

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:

Adults needing mechanical ventilation who were sedated with dexmedetomidine had reduced length of stay in intensive care and reduced duration of ventilation.

Various sedative drugs are available for use in England although it is unclear if one is better than the others. This review compared two alpha-2 agonist drugs (clonidine and dexmedetomidine) to other commonly used sedative drugs: propofol and the benzodiazepines midazolam and lorazepam for adults on mechanical ventilation.

A 2014 survey reported that, while clonidine is used in about a third of units, dexmedetomidine is not frequently used. The latter drug is expensive, and this review did not consider cost-effectiveness which will be an important factor if the drug is to be used more widely.

This review’s findings on dexmedetomidine support best practice guidelines which suggest modest benefits for non-benzodiazepines compared to benzodiazepines.

Brief description of media:

A five-day educational course showed potential to reduce work-based stress and burnout among nurses working in intensive care units in France. The study conducted in multiple adult intensive care units aimed to identify the effects of an intensive, continuing medical education program on occupational stress.

The course focussed on nursing theory, role-play and debriefing sessions. Six months after attending the programme, intensive care unit nurses showed reduced levels of job strain compared to their counterparts who had not received the course.

This study showed that a relatively short programme of training helped to reduce stress, sick leave and improve staff retention among intensive care unit nurses in the short- to medium-term. It is not known whether these effects have a lasting impact. This was a small-scale study of 198 nurses with different education and training systems. The results may need adapting and validating within a UK setting, but this study provides a useful addition to a growing evidence base on workplace learning and wellbeing.

Brief description of media:

ICU survivors suffer from long-lasting physical, mental, and cognitive health impairments, also called "postintensive care syndrome". However, an overview of the effectiveness of interventions to prevent or mitigate these impairments is lacking. The aim of this study is to assess the effectiveness of nonpharmacologic interventions.

Brief description of media:

Evidence-based recommendations on normothermic extracorporeal preservation of hearts for transplant after brainstem death. This technique is used to store a donor heart for longer before being transplanted.