Recovery and outcomes after the acute respiratory distress syndrome (ARDS) in patients and their family caregivers

Abstract

Outcomes after acute respiratory distress syndrome (ARDS) are similar to those of other survivors of critical illness and largely affect the nerve, muscle, and central nervous system but also include a constellation of varied physical devastations ranging from contractures and frozen joints to tooth loss and cosmesis. Compromised quality of life is related to a spectrum of impairment of physical, social, emotional, and neurocognitive function and to a much lesser extent discrete pulmonary disability. Intensive care unit-acquired weakness (ICUAW) is ubiquitous and includes contributions from both critical illness polyneuropathy and myopathy, and recovery from these lesions may be incomplete at 5 years after ICU discharge. Cognitive impairment in ARDS survivors ranges from 70 to 100 % at hospital discharge, 46 to 80 % at 1 year, and 20 % at 5 years, and mood disorders including depression and post-traumatic stress disorder (PTSD) are also sustained and prevalent. Robust multidisciplinary and longitudinal interventions that improve these outcomes are still uncertain and data in our literature are conflicting. Studies are needed in family members of ARDS survivors to better understand long-term outcomes of the post-ICU family syndrome and to evaluate how it affects patient recovery.

Long-Term Outcomes of Out-of-Hospital Cardiac Arrest Care at Regionalized Centers

“…Finally, while we report associations with long-term survival after OHCA, quality of life and degree of functional recovery for these survivors is unknown. Survivors of critical illness in general, 32–34 and anoxic brain injury specifically, 35, 36 may experience significant functional, cognitive and psychological limitations. In the United States, the National Death Index aggregates data from death certificates, which can be used to determine individuals’ vital status.…”

Regulation of lung endothelial permeability by NEK kinases

“…Those who survive the devastations of that syndrome show outcomes similar to those who overcome critical illness. They present impaired nerve, muscle, and central nervous system functionality, and are subjected to anxiety, depression, and post‐traumatic stress disorder (PTSD) . Thus, the exploration of novel therapeutic possibilities against ARDS is of the utmost need.…”

Critical illness: the brain is always in the line of fire

“…Although the prevalence of post-ICU cognitive impairment declines over time, it can be long-lasting in some patients. In one study, 20% of survivors of ARDS had residual cognitive impairment 5 years after hospital discharge [8]. However, the exact scale of the problem is uncertain because of the large variability in studies investigating cognitive outcomes after critical illness.…”