Acute Respiratory Failure Survivors’ Physical, Cognitive, and Mental Health Outcomes: Quantitative Measures versus Semistructured Interviews

Nelliot, Archana; Dinglas, Victor D.; O’Toole, Jacqueline; Patel, Yashika; Mendez-Tellez, Pedro A.; Nabeel, Mohammed; Friedman, Lisa Aronson; Hough, Catherine L.; Hopkins, Ramona O.; Eakin, Michelle N.

doi:10.1513/annalsats.201812-851oc

Cited by 18 publications

(26 citation statements)

References 34 publications

(38 reference statements)

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“…And third, the question is whether commonly used standardized outcome measures, such as the SF-36 and HADS, adequately reflect patients’ experiences. A previous study, in which standardized outcome measures were compared with findings from qualitative interviews, concluded that it is reliable to use standardized outcome measures for physical and mental health impairment ( 58 ). However, they emphasized that caution is needed in interpreting self-reported cognitive function.…”

Section: Discussionmentioning

confidence: 99%

Physical, Mental, and Cognitive Health Status of ICU Survivors Before ICU Admission: A Cohort Study

Geense¹,

Boogaard²,

Peters

et al. 2020

Critical Care Medicine

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Section: Discussionmentioning

confidence: 99%

Physical, Mental, and Cognitive Health Status of ICU Survivors Before ICU Admission: A Cohort Study

Geense¹,

Boogaard²,

Peters

et al. 2020

Critical Care Medicine

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“…None of our patients presented with delirium, as often observed in ARDS or in post-intensive care syndrome (PICS). [32][33][34][35] PICS can also be accompanied by long-term cognitive impairments, especially regarding memory, executive functions, language, attention, and visual-spatial abilities. [32,35] Thus, part of our results could be related to PICS, although we showed that patients who benefited from the most invasive respiratory assistance had better preserved cognitive functions and did not show worse mood alterations, compared to the other groups.…”

Section: Discussionmentioning

confidence: 99%

Covid-19 Cognitive Deficits After Respiratory Assistance in the Subacute Phase: A Covid-Rehabilitation Unit Experience

Alemanno

Houdayer

Parma

et al. 2020

Preprint

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IntroductionCOVID-19 complications can include neurological, psychiatric, psychological, and psychosocial impairments. Little is known on the consequences of SARS-COV-2 on cognitive functions of patients in the sub-acute phase of the disease. We aimed to investigate the impact of COVID-19 on cognitive functions of patients admitted to the COVID-19 Rehabilitation Unit of the San Raffaele Hospital (Milan, Italy).Material and Methods87 patients admitted to the COVID-19 Rehabilitation Unit from March 27th to June 20th 2020 were included. Patients underwent Mini Mental State Evaluation (MMSE), Montreal Cognitive Assessment (MoCA), Hamilton Rating Scale for Depression, and Functional Independence Measure (FIM). Data were divided in 4 groups according to the respiratory assistance in the acute phase: Group1 (orotracheal intubation), Group2 (non-invasive ventilation using Biphasic Positive Airway Pressure), Group3 (Venturi Masks), Group4 (no oxygen therapy). Follow-ups were performed at one month after home-discharge.ResultsOut of the 87 patients (62 Male, mean age 67.23 ± 12.89 years), 80% had neuropsychological deficits (MoCA and MMSE) and 40% showed mild-to-moderate depression. Group1 had higher scores than Group3 for visuospatial/executive functions (p=0.016), naming (p=0.024), short- and long-term memory (p=0.010, p=0.005), abstraction (p=0.024), and orientation (p=0.034). Group1 was younger than Groups2 and 3. Cognitive impairments correlated with patients’ age. Only 18 patients presented with anosmia. Their data did not differ from the other patients. FIM (<100) did not differ between groups. Patients partly recovered at one-month follow-up and 43% showed signs of post-traumatic stress disorder.ConclusionPatients with severe functional impairments had important cognitive and emotional deficits which might have been influenced by the choice of ventilatory therapy, but mostly appeared to be related to aging, independently of FIM scores. These findings should be integrated for decision-making in respiratory and neuropsychiatric assistance of COVID-19 patients in the subacute phase of the disease, and show the need for long-term support and psychological treatment of post-COVID-19 patients.

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“…The most frequently reported mitigation strategies for performing the prone maneuver were: one person being at the head of the patient (23 6). The overall median (min-max) number of staff members involved in the prone positioning maneuver was 5 (3)(4)(5)(6)(7)(8) in the original studies and 5 (3)(4)(5)(6)(7) in the recommendations, mainly including physicians, nurses, and respiratory therapists. Additionally, the training of staff members involved in the management of patients placed in the prone position was reported in only 11 (39.3%) original studies, and was suggested by eight (61.5%) recommendation documents.…”

Section: Mitigation Strategies For Adverse Events Related To Prone Positioningmentioning

confidence: 99%

“…Acute respiratory distress syndrome (ARDS) has a mortality rate between 20% and 48% [1][2][3] and survivors commonly experience long-term physical, cognitive, and mental impairments 4,5 . Prone positioning is among the well-known strategies to counteract ARDS [6][7][8] , and is an inexpensive intervention that requires no complex technology, making it feasible worldwide 9 .…”

Section: Introductionmentioning

confidence: 99%

Adverse Events of Prone Positioning in Mechanically Ventilated Adults With ARDS

et al. 2021

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INTRODUCTION: Prone positioning is a therapy utilized globally to improve gas exchange, minimize ventilator-induced lung injury, and reduce mortality in acute respiratory distress syndrome (ARDS), particularly during the ongoing coronavirus disease 2019 (COVID-19) pandemic. While the respiratory benefits of prone positioning in ARDS have been accepted, the concurrent complications could be undervalued. Therefore, this study aimed to identify the adverse events related to prone positioning in ARDS, and secondarily, to collect strategies and recommendations to mitigate these adverse events. METHODS: In this scoping review, we searched recommendation documents and original studies published between June 2013 and November 2020 from six relevant electronic databases and the websites of intensive care societies. RESULTS: We selected 41 documents from 121 eligible documents, comprising 13 recommendation documents and 28 original studies (involving 1,578 patients and 994 prone maneuvers). We identified more than 40 individual adverse events, and the highest pooled occurrence rates were that of severe desaturation (37.9%), barotrauma (30.5%), pressure sores (29.7%), ventilationassociated pneumonia (28.2%), facial edema (16.7%), arrhythmia (15.4%), hypotension (10.2%), and peripheral nerve injuries (8.1%). The reported mitigation strategies during prone positioning include alternate face rotation (18 [43.9%]), repositioning every 2 hours (17 [41.5%]), and the use of pillows under the chest and pelvis (14 [34.1%]). The reported mitigation strategies for performing the prone maneuver comprise one person being at the headboard (23 [56.1%]), the use of a pre-maneuver safety checklist (18 [43.9%]), vital sign monitoring (15 [36.6%]), and ensuring appropriate ventilator settings (12 [29.3%]). CONCLUSIONS: We identified >40 adverse events reported in prone positioning ARDS studies, involving additional AEs not yet reported by previous systematic reviews. The Page 3 of 43 Respiratory Care 4 pooled adverse event proportions collected in this review could guide research and clinical practice decisions, and the strategies to mitigate adverse events could promote future consensus-based recommendations.

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Acute Respiratory Failure Survivors’ Physical, Cognitive, and Mental Health Outcomes: Quantitative Measures versus Semistructured Interviews

Cited by 18 publications

References 34 publications

Physical, Mental, and Cognitive Health Status of ICU Survivors Before ICU Admission: A Cohort Study

Physical, Mental, and Cognitive Health Status of ICU Survivors Before ICU Admission: A Cohort Study

Covid-19 Cognitive Deficits After Respiratory Assistance in the Subacute Phase: A Covid-Rehabilitation Unit Experience

Adverse Events of Prone Positioning in Mechanically Ventilated Adults With ARDS

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