COVID-19 pandemic in the intensive care unit: Psychological implications and interventions, a systematic review

Abstract

BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic produced changes in intensive care units (ICUs) in patient care and health organizations. The pandemic event increased patients’ risk of developing psychological symptoms during and after hospitalisation. These consequences also affected those family members who could not access the hospital. In addition, the initial lack of knowledge about the virus and its management, the climate of fear and uncertainty, the increased workload and the risk of becoming infected and being contagious, had a strong impact on healthcare staff and organizations. This highlighted the importance of interventions aimed at providing psychological support to ICUs, involving patients, their relatives, and the staff; this might involve the reorganisation of the daily routine and rearrangement of ICU staff duties. AIM To conduct a systematic review of psychological issues in ICUs during the COVID-19 pandemic involving patients, their relatives, and ICU staff. METHODS We investigated the PubMed and the ClinicalTrials.gov databases and found 65 eligible articles, upon which we commented. RESULTS Our results point to increased perceived stress and psychological distress in staff, patients and their relatives and increased worry for being infected with severe acute respiratory syndrome coronavirus-2 in patients and relatives. Furthermore, promising results were obtained for some psychological programmes aiming at improving psychological measures in all ICU categories. CONCLUSION As the pandemic limited direct inter-individual interactions, the role of interventions using digital tools and virtual reality is becoming increasingly important. All considered, our results indicate an essential role for psychologists in ICUs.

Post intensive care syndrome: A review of clinical symptoms, evaluation, intervention

“…Upon admission, patients often experience mental symptoms such as agitation, irritability, and depression, which can be attributed to their lack of familiarity with the ICU environment and the associated fear it entails [ 89 ]. Research indicates that timely assessment of the mental state of ICU patients, combined with psychological treatments like psychoeducation, music therapy, and access to electronic devices like phones and laptops, has the potential to prevent and reduce psychological distress such as anxiety, depression, guilt, and social isolation [ 90 ]. These interventions are essential as they not only minimize these symptoms but also decrease the likelihood of developing PICS in ICU survivors.…”

Man Versus Machine: Provider Directed Versus Precision Automated Critical Care Management in a Porcine Model of Distributive Shock

“…The cognitive load associated with these tasks can lead to errors, provider burnout, and overall worse outcomes for patients (14–17). Moreover, the burden on critical care providers has significantly increased in recent years, particularly during the COVID-19 pandemic (18–21). These patients frequently required invasive hemodynamic devices with continuous data, where subtle physiologic changes can be difficult to perceive.…”