Post-Intensive Care Syndrome

Olesen, Tilde Skovkær Withen; Kruse, Mary; Pawlowicz-Dworzanska, Malgorzata B.; Klostergaard, Kirsten; Leutscher, Peter

doi:10.1007/978-3-030-24250-3

Cited by 12 publications

(1 citation statement)

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“…Surviving critical care impacts many aspects of physical, cognitive and psychological function, often described as 'Post intensive care unit [ICU] Syndrome. 1,2 Rehabilitation needs can thus be complex. 3,4 In particular, COVID-19 ICU survivors face all the general impacts of ICU care, but with additional disease specific features 5 and possible sustained post-infective elements ('Long COVID'), [6][7][8][9] As yet, however, there is no systematic collection of data to identify the individual rehabilitation needs of patients as they leave critical and acute hospital care, or to inform the planning and development of rehabilitation services.…”

Section: Introductionmentioning

confidence: 99%

The post-ICU presentation screen (PICUPS) and rehabilitation prescription (RP) for intensive care survivors part I: Development and preliminary clinimetric evaluation

Turner‐Stokes

Corner

Siegert

et al. 2021

Journal of the Intensive Care Society

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Background Patients who have had prolonged stays in intensive care have ongoing rehabilitation needs. This is especially true of COVID-19 ICU patients, who can suffer diverse long-term ill effects. Currently there is no systematic data collection to guide the needs for therapy input for either of these groups nor to inform planning and development of rehabilitation services. These issues could be resolved in part by the systematic use of a clinical tool to support decision-making as patients progress from the Intensive Care Unit (ICU), through acute hospital care and onwards into rehabilitation. We describe (i) the development of such a tool (the Post-ICU Presentation Screen (PICUPS)) and (ii) the subsequent preparation of a person-centred Rehabilitation Prescription (RP) to travel with the patient as they continue down the care pathway. Methods PICUPS development was led by a core group of experienced clinicians representing the various disciplines involved in post-ICU rehabilitation. Key constructs and item-level descriptors were identified by group consensus. Piloting was performed as part of wider clinical engagement in 26 acute hospitals across England. Development and validation of such a tool requires clinimetric analysis, and this was based on classical test theory. Teams also provided feedback about the feasibility and utility of the tool. Results Initial PICUPS design yielded a 24-item tool. In piloting, a total of 552 records were collated from 314 patients, of which 121 (38.5%) had COVID-19. No obvious floor or ceiling effects were apparent. Exploratory factor analysis provided evidence of uni-dimensionality with strong loading on the first principal component accounting for 51% of the variance and Cronbach’s alpha for the full-scale score 0.95 – although a 3-factor solution accounted for a further 21%. The PICUPS was responsive to change both at full scale- and item-level. In general, positive responses were seen regarding the tool’s ability to describe the patients during their clinical course, engage and flag the relevant professionals needed, and to inform what should be included in an RP. Conclusions The PICUPS tool has robust scaling properties as a clinical measure and is potentially useful as a tool for identifying rehabilitation needs as patients step down from ICU and acute hospital care.

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Section: Introductionmentioning

confidence: 99%

The post-ICU presentation screen (PICUPS) and rehabilitation prescription (RP) for intensive care survivors part I: Development and preliminary clinimetric evaluation

Turner‐Stokes

Corner

Siegert

et al. 2021

Journal of the Intensive Care Society

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Post-intensive care syndrome and health-related quality of life in long-term survivors of cardiac arrest: a prospective cohort study

Amacher,

Sahmer,

Becker

et al. 2024

Sci Rep

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Patients discharged from intensive care are at risk for post-intensive care syndrome (PICS), which consists of physical, psychological, and/or neurological impairments. This study aimed to analyze PICS at 24 months follow-up, to identify potential risk factors for PICS, and to assess health-related quality of life in a long-term cohort of adult cardiac arrest survivors. This prospective cohort study included adult cardiac arrest survivors admitted to the intensive care unit of a Swiss tertiary academic medical center. The primary endpoint was the prevalence of PICS at 24 months follow-up, defined as impairments in physical (measured through the European Quality of Life 5-Dimensions-3-Levels instrument [EQ-5D-3L]), neurological (defined as Cerebral Performance Category Score > 2 or Modified Rankin Score > 3), and psychological (based on the Hospital Anxiety and Depression Scale and the Impact of Event Scale-Revised) domains. Among 107 cardiac arrest survivors that completed the 2-year follow-up, 46 patients (43.0%) had symptoms of PICS, with 41 patients (38.7%) experiencing symptoms in the physical domain, 16 patients (15.4%) in the psychological domain, and 3 patients (2.8%) in the neurological domain. Key predictors for PICS in multivariate analyses were female sex (adjusted odds ratio [aOR] 3.17, 95% CI 1.08 to 9.3), duration of no-flow interval during cardiac arrest (minutes) (aOR 1.17, 95% CI 1.02 to 1.33), post-discharge job-loss (aOR 31.25, 95% CI 3.63 to 268.83), need for ongoing psychological support (aOR 3.64, 95% CI 1.29 to 10.29) or psychopharmacologic treatment (aOR 9.49, 95% CI 1.9 to 47.3), and EQ-visual analogue scale (points) (aOR 0.88, 95% CI 0.84 to 0.93). More than one-third of cardiac arrest survivors experience symptoms of PICS 2 years after resuscitation, with the highest impairment observed in the physical and psychological domains. However, long-term survivors of cardiac arrest report intact health-related quality of life when compared to the general population. Future research should focus on appropriate prevention, screening, and treatment strategies for PICS in cardiac arrest patients.

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PICS – Welche Nachsorge benötigen Betroffene?

Emsden,

Schütz

2023

intensiv

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Die Langzeitfolgen einer kritischen Erkrankung sind in den Fokus der Intensivstationen gerückt. Innerhalb der Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin wurde kürzlich die Sektion PICS gegründet, um sich im multiprofessionellen Austausch dem Thema zu widmen. Einen Einblick in die Nachsorge von PICS-Betroffenen geben die Autoren dieses Artikels anhand einer Literaturübersicht und eines Erfahrungsberichts von mehr als sechs Jahren in einer Post-ICU-Sprechstunde.

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Post-Intensive Care Syndrome

Cited by 12 publications

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The post-ICU presentation screen (PICUPS) and rehabilitation prescription (RP) for intensive care survivors part I: Development and preliminary clinimetric evaluation

The post-ICU presentation screen (PICUPS) and rehabilitation prescription (RP) for intensive care survivors part I: Development and preliminary clinimetric evaluation

Post-intensive care syndrome and health-related quality of life in long-term survivors of cardiac arrest: a prospective cohort study

PICS – Welche Nachsorge benötigen Betroffene?

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