One-Year Outcomes of Postintensive Care Syndrome in Critically Ill Coronavirus Disease 2019 Patients: A Single Institutional Study

Banno, Aya; Hifumi, Toru; Takahashi, Yuta; Soh, Mitsuhito; Sakaguchi, Ayako; Shimano, Shodai; Miyahara, Yoshie; Isokawa, Shutaro; Ishii, Kenji; Aoki, Kazuhiro; Otani, Norio; Ishimatsu, Shinichi

doi:10.1097/cce.0000000000000595

Cited by 12 publications

(10 citation statements)

References 32 publications

(64 reference statements)

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“…It has also not yet been possible to clarify the extent to which the increased sedation requirements mentioned above are related to post-intensive care syndrome (PICS). Late sequelae of severe COVID-19 infection observed in the context of PICS include not only physical but also neurological impairment and a reduced quality of life [56,57]. A link via neuroinflammation would be conceivable and should be investigated further.…”

Section: Discussionmentioning

confidence: 99%

Associated Factors of High Sedative Requirements within Patients with Moderate to Severe COVID-19 ARDS

Flinspach

Booke

Zacharowski

et al. 2022

JCM

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The coronavirus pandemic continues to challenge global healthcare. Severely affected patients are often in need of high doses of analgesics and sedatives. The latter was studied in critically ill coronavirus disease 2019 (COVID-19) patients in this prospective monocentric analysis. COVID-19 acute respiratory distress syndrome (ARDS) patients admitted between 1 April and 1 December 2020 were enrolled in the study. A statistical analysis of impeded sedation using mixed-effect linear regression models was performed. Overall, 114 patients were enrolled, requiring unusual high levels of sedatives. During 67.9% of the observation period, a combination of sedatives was required in addition to continuous analgesia. During ARDS therapy, 85.1% (n = 97) underwent prone positioning. Veno-venous extracorporeal membrane oxygenation (vv-ECMO) was required in 20.2% (n = 23) of all patients. vv-ECMO patients showed significantly higher sedation needs (p < 0.001). Patients with hepatic (p = 0.01) or renal (p = 0.01) dysfunction showed significantly lower sedation requirements. Except for patient age (p = 0.01), we could not find any significant influence of pre-existing conditions. Age, vv-ECMO therapy and additional organ failure could be demonstrated as factors influencing sedation needs. Young patients and those receiving vv-ECMO usually require increased sedation for intensive care therapy. However, further studies are needed to elucidate the causes and mechanisms of impeded sedation.

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Section: Discussionmentioning

confidence: 99%

Associated Factors of High Sedative Requirements within Patients with Moderate to Severe COVID-19 ARDS

Flinspach

Booke

Zacharowski

et al. 2022

JCM

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“… 7 Previously, several prospective studies found a high prevalence of functional impairment in survivors of critical COVID-19 survivors. 8 , 16 , 17 Instead, Rosseau et al in a prospective study in 33 patients with COVID-19 in Belgium, observed that the cognitive domain was the most frequently affected (47%) 3 months after ICU discharge; and only 31% presented with functional dependence. 18 Patients in this cohort were younger, had less severity of illness on admission, and fewer days on mechanical ventilation and ICU stay than our patients.…”

Section: Discussionmentioning

confidence: 99%

“…These findings are in line with other studies conducted in patients with ARDS of different etiologies, demonstrating that the risk factors that may contribute to PICS development after critical illness due to COVID-19 are likely to be not different from PICS development from other etiologies. 7 , 16 , 19 , 20 However, the obesity impact on the functional dependence at medium or long term has not been sufficiently studied. Numerous studies indicate that obesity is associated with increased disease severity and mortality in patients with COVID-19 while others conducted in patients with non-COVID-19 associated ARDS showed a "paradoxical or protective effect" of obesity on mortality.…”

Section: Discussionmentioning

confidence: 99%

Post intensive care syndrome in survivors of COVID-19 who required mechanical ventilation during the third wave of the pandemic: A prospective study

Martínez,

Aguilera,

Márquez

et al. 2023

Heart & Lung

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“…Critical illness survivors exhibit high levels of post-ICU physical, cognitive, and mental impairments, requiring considerable and often new-onset family caregiving [ 8 , 68 , 126 – 128 ]. Given the increased prevalence of critically ill patients due to the COVID-19 pandemic, who have a high prevalence of post-intensive care syndrome [ 129 , 130 ], more families are affected by the health impact of critical illness. In addition, pandemic-related access restrictions increase family suffering and risk for negative health outcomes [ 12 , 13 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

A multicomponent family support intervention in intensive care units: study protocol for a multicenter cluster-randomized trial (FICUS Trial)

Naef

Filipovic

Jeitziner

et al. 2022

Trials

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Background Family members of critically ill patients face considerable uncertainty and distress during their close others’ intensive care unit (ICU) stay. About 20–60% of family members experience adverse mental health outcomes post-ICU, such as symptoms of anxiety, depression, and posttraumatic stress. Guidelines recommend structured family inclusion, communication, and support, but the existing evidence base around protocolized family support interventions is modest and requires substantiation. Methods To test the clinical effectiveness and explore the implementation of a multicomponent, nurse-led family support intervention in ICUs, we will undertake a parallel, cluster-randomized, controlled, multicenter superiority hybrid-type 1 trial. It will include eight clusters (ICUs) per study arm, with a projected total sample size of 896 family members of adult, critically ill patients treated in the German-speaking part of Switzerland. The trial targets family members of critically ill patients with an expected ICU stay of 48 h or longer. Families in the intervention arm will receive a family support intervention in addition to usual care. The intervention consists of specialist nurse support that is mapped to the patient pathway with follow-up care and includes psycho-educational and relationship-focused family interventions, and structured, interprofessional communication, and shared decision-making with families. Families in the control arm will receive usual care. The primary study endpoint is quality of family care, operationalized as family members’ satisfaction with ICU care at discharge. Secondary endpoints include quality of communication and nurse support, family management of critical illness (functioning, resilience), and family members’ mental health (well-being, psychological distress) measured at admission, discharge, and after 3, 6, and 12 months. Data of all participants, regardless of protocol adherence, will be analyzed using linear mixed-effects models, with the individual participant as the unit of inference. Discussion This trial will examine the effectiveness of the family support intervention and generate knowledge of its implementability. Both types of evidence are necessary to determine whether the intervention works as intended in clinical practice and could be scaled up to other ICUs. The study findings will make a significant contribution to the current body of knowledge on effective ICU care that promotes family participation and well-being. Trial registration ClinicalTrials.gov NCT05280691. Prospectively registered on 20 February 2022.

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One-Year Outcomes of Postintensive Care Syndrome in Critically Ill Coronavirus Disease 2019 Patients: A Single Institutional Study

Abstract: Supplemental Digital Content is available in the text.

Cited by 12 publications

References 32 publications

Associated Factors of High Sedative Requirements within Patients with Moderate to Severe COVID-19 ARDS

Associated Factors of High Sedative Requirements within Patients with Moderate to Severe COVID-19 ARDS

Post intensive care syndrome in survivors of COVID-19 who required mechanical ventilation during the third wave of the pandemic: A prospective study

A multicomponent family support intervention in intensive care units: study protocol for a multicenter cluster-randomized trial (FICUS Trial)

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