Improving long-term outcomes after discharge from intensive care unit: report from a stakeholders' conference.

Abstract:

BACKGROUND:Millions of patients are discharged from intensive care units annually. These intensive care survivors and their families frequently report a wide range of impairments in their health status which may last for months and years after hospital discharge. OBJECTIVES:To report on a 2-day Society of Critical Care Medicine conference aimed at improving the long-term outcomes after critical illness for patients and their families. PARTICIPANTS:Thirty-one invited stakeholders participated in the conference. Stakeholders represented key professional organizations and groups, predominantly from North America, which are involved in the care of intensive care survivors after hospital discharge. DESIGN:Invited experts and Society of Critical Care Medicine members presented a summary of existing data regarding the potential long-term physical, cognitive and mental health problems after intensive care and the results from studies of postintensive care unit interventions to address these problems. Stakeholders provided reactions, perspectives, concerns and strategies aimed at improving care and mitigating these long-term health problems. MEASUREMENTS AND MAIN RESULTS:Three major themes emerged from the conference regarding: (1) raising awareness and education, (2) understanding and addressing barriers to practice, and (3) identifying research gaps and resources. Postintensive care syndrome was agreed upon as the recommended term to describe new or worsening problems in physical, cognitive, or mental health status arising after a critical illness and persisting beyond acute care hospitalization. The term could be applied to either a survivor or family member. CONCLUSIONS:Improving care for intensive care survivors and their families requires collaboration between practitioners and researchers in both the inpatient and outpatient settings. Strategies were developed to address the major themes arising from the conference to improve outcomes for survivors and families.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Needham DM,Davidson J,Cohen H,Hopkins RO,Weinert C,Wunsch H,Zawistowski C,Bemis-Dougherty A,Berney SC,Bienvenu OJ,Brady SL,Brodsky MB,Denehy L,Elliott D,Flatley C,Harabin AL,Jones C,Louis D,Meltzer W,Muldoon SR,Pa

doi

10.1097/CCM.0b013e318232da75

subject

Has Abstract

pub_date

2012-02-01 00:00:00

pages

502-9

issue

2

eissn

0090-3493

issn

1530-0293

journal_volume

40

pub_type

杂志文章,评审
  • Pulse oximetry in sickle cell anemia.

    abstract:OBJECTIVES:To determine whether pulse oximetry is accurate and if it correlates with arterial blood gas saturation in pediatric patients with sickle cell anemia. DESIGN:Prospective, comparative study using a convenience sample of patients with sickle cell anemia who had simultaneous arterial blood gas sampling and pul...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-200109000-00025

    authors: Fitzgerald RK,Johnson A

    更新日期:2001-09-01 00:00:00

  • Meconium and amniotic fluid embolism: effects on coagulation in pregnant mini-pigs.

    abstract:OBJECTIVE:A hallmark of amniotic fluid embolism is the induction of coagulation defects. Little is known about the nature of these defects or the causative agent or agents. The purpose of this study was to assess the effects of meconium containing (native) meconium-amniotic-fluid infusion (MAFI) and meconium-free (cent...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199902000-00042

    authors: Petroianu GA,Altmannsberger SH,Maleck WH,Assmus HP,Friedberg C,Bergler WF,Rüfer R

    更新日期:1999-02-01 00:00:00

  • The hepatoadrenal syndrome: a common yet unrecognized clinical condition.

    abstract:OBJECTIVE:Adrenal failure is common in critically ill patients, particularly those with sepsis. As liver failure and sepsis are both associated with increased circulating levels of endotoxin and proinflammatory mediators and reduced levels of apoprotein-1/high-density lipoprotein, we postulated that adrenal failure may...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.ccm.0000164541.12106.57

    authors: Marik PE,Gayowski T,Starzl TE,Hepatic Cortisol Research and Adrenal Pathophysiology Study Group.

    更新日期:2005-06-01 00:00:00

  • Incidence and prognosis of early hepatic dysfunction in critically ill patients--a prospective multicenter study.

    abstract:OBJECTIVE:In critically ill patients, hepatic dysfunction is regarded as a late organ failure associated with poor prognosis. We investigated the incidence and prognostic implications of early hepatic dysfunction (serum bilirubin >2 mg/dL within 48 hrs of admission). DESIGN:Prospective, multicenter cohort study. SETT...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1097/01.CCM.0000259462.97164.A0

    authors: Kramer L,Jordan B,Druml W,Bauer P,Metnitz PG,Austrian Epidemiologic Study on Intensive Care, ASDI Study Group.

    更新日期:2007-04-01 00:00:00

  • The Nursing Activities Score Per Nurse Ratio Is Associated With In-Hospital Mortality, Whereas the Patients Per Nurse Ratio Is Not.

    abstract:OBJECTIVES:Studies have shown contradicting results on the association of nursing workload and mortality. Most of these studies expressed workload as patients per nurse ratios; however, this does not take into account that some patients require more nursing time than others. Nursing time can be quantified by tools like...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000004005

    authors: Margadant C,Wortel S,Hoogendoorn M,Bosman R,Spijkstra JJ,Brinkman S,de Keizer N

    更新日期:2020-01-01 00:00:00

  • Fever in adult ICUs: an interrupted time series analysis*.

    abstract:OBJECTIVES:Fever is common and associated with increased mortality among patients admitted to adult ICUs, yet recent literature suggests that the incidence of fever may be decreasing. The objective of this study was to determine whether the incidence of fever in adult ICUs changed over time and the factors responsible ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e31828a43b2

    authors: Niven DJ,Stelfox HT,Shahpori R,Laupland KB

    更新日期:2013-08-01 00:00:00

  • Reduced encephalopathy in pigs with ischemia-induced acute hepatic failure treated with a bioartificial liver containing alginate-entrapped hepatocytes.

    abstract:OBJECTIVE:To analyze the effects of an extracorporeal bioartificial liver containing alginate bead-entrapped hepatocytes on pigs with ischemia-induced acute hepatic failure. DESIGN:Prospective animal study. SETTING:University and INSERM laboratory. SUBJECTS:Fifteen Large White/Pietrin female pigs weighing 20-30 kg. ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-200203000-00027

    authors: Desille M,Mahler S,Seguin P,Mallédant Y,Frémond B,Sébille V,Bouix A,Desjardins JF,Joly A,Desbois J,Lebreton Y,Campion JP,Clément B

    更新日期:2002-03-01 00:00:00

  • Sleep and Work in ICU Physicians During a Randomized Trial of Nighttime Intensivist Staffing.

    abstract:OBJECTIVES:To compare sleep, work hours, and behavioral alertness in faculty and fellows during a randomized trial of nighttime in-hospital intensivist staffing compared with a standard daytime intensivist model. DESIGN:Prospective observational study. SETTING:Medical ICU of a tertiary care academic medical center du...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000003773

    authors: Bakhru RN,Basner M,Kerlin MP,Halpern SD,Hansen-Flaschen J,Rosen IM,Dinges DF,Schweickert WD

    更新日期:2019-07-01 00:00:00

  • Stem cells in sepsis and acute lung injury.

    abstract:OBJECTIVE:Sepsis and acute lung injury continue to be major causes of morbidity and mortality worldwide despite advances in our understanding of pathophysiology and the discovery of new management strategies. Recent investigations show that stem cells may be beneficial as prognostic biomarkers and novel therapeutic str...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/CCM.0b013e3181f96f5f

    authors: Cribbs SK,Matthay MA,Martin GS

    更新日期:2010-12-01 00:00:00

  • Ultrafilterable hypomagnesemia in neonates admitted to the neonatal intensive care unit.

    abstract:OBJECTIVE:To evaluate the frequency and clinical correlates of ultrafilterable hypomagnesemia in neonates admitted to the neonatal intensive care unit (ICU). DESIGN:Prospective, observational study. SETTING:Massachusetts General Hospital and Mount Auburn Hospital. PATIENTS:A total of 117 patients (84 neonatal ICU pa...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199405000-00017

    authors: Munoz R,Khilnani P,Ziegler J,Salem M,Catlin EA,Nussbaum S,Todres ID,Chernow B

    更新日期:1994-05-01 00:00:00

  • Racial Differences in Palliative Care Use After Stroke in Majority-White, Minority-Serving, and Racially Integrated U.S. Hospitals.

    abstract:OBJECTIVES:Racial/ethnic differences in palliative care resource use after stroke have been recognized, but it is unclear whether patient or hospital characteristics drive this disparity. We sought to determine whether palliative care use after intracerebral hemorrhage and ischemic stroke differs between hospitals serv...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000002762

    authors: Faigle R,Ziai WC,Urrutia VC,Cooper LA,Gottesman RF

    更新日期:2017-12-01 00:00:00

  • The influence of prehospital systemic corticosteroid use on development of acute respiratory distress syndrome and hospital outcomes.

    abstract:OBJECTIVE:The role of systemic corticosteroids in pathophysiology and treatment of acute respiratory distress syndrome is controversial. Use of prehospital systemic corticosteroid therapy may prevent the development of acute respiratory distress syndrome and improve hospital outcomes. DESIGN:This is a preplanned retro...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1097/CCM.0b013e31828a1fc7

    authors: Karnatovskaia LV,Lee AS,Gajic O,Festic E,U.S. Critical Illness and Injury Trials Group: Lung Injury Prevention Study Investigators (USCIITG–LIPS).

    更新日期:2013-07-01 00:00:00

  • Transient receptor potential melastatin 8 channel inhibition potentiates the hypothermic response to transient receptor potential vanilloid 1 activation in the conscious mouse.

    abstract:OBJECTIVES:Mild decrease in core temperature (therapeutic hypothermia) provides lasting neuroprotection following cardiac arrest or cerebral ischemia. However, current methods for producing therapeutic hypothermia trigger a cold-defense response that must be countered by sedatives, muscle paralytics, and mechanical ven...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000000229

    authors: Feketa VV,Zhang Y,Cao Z,Balasubramanian A,Flores CM,Player MR,Marrelli SP

    更新日期:2014-05-01 00:00:00

  • Thrombocytopenia in patients in the medical intensive care unit: bleeding prevalence, transfusion requirements, and outcome.

    abstract:OBJECTIVE:To determine prevalence, risk factors, and outcome of thrombocytopenia in medical intensive care patients. DESIGN:Prospective observational study. SETTING:The 12-bed medical intensive care unit of a university hospital. PATIENTS:All consecutively admitted patients with normal platelet count at admission an...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-200208000-00015

    authors: Strauss R,Wehler M,Mehler K,Kreutzer D,Koebnick C,Hahn EG

    更新日期:2002-08-01 00:00:00

  • Neuroprotective effects of argon in an in vivo model of transient middle cerebral artery occlusion in rats.

    abstract:OBJECTIVE:The neuroprotective effects of the noble gas xenon are well known. Argon, in contrast to xenon, is abundant, inexpensive, and therefore widely applicable. In this study, we analyzed the possible neuroprotective role of argon in an in vivo rat model of acute focal cerebral ischemia. DESIGN:Controlled laborato...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e31821209be

    authors: Ryang YM,Fahlenkamp AV,Rossaint R,Wesp D,Loetscher PD,Beyer C,Coburn M

    更新日期:2011-06-01 00:00:00

  • Are autopsy findings still relevant to the management of critically ill patients in the modern era?

    abstract:OBJECTIVES:The purpose of this study was to determine the accuracy of clinical diagnoses compared to autopsy findings in critically ill patients in the current medical era. DESIGN:We conducted a retrospective, blinded review of matched medical records and postmortem findings in patients who died between June 2006 and ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e3182a275b1

    authors: Fröhlich S,Ryan O,Murphy N,McCauley N,Crotty T,Ryan D

    更新日期:2014-02-01 00:00:00

  • Venous Thromboembolism Events Following Venovenous Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Syndrome Coronavirus 2 Based on CT Scans.

    abstract:OBJECTIVES:The main objective of the study was to determine the prevalence of venous thromboembolism events in patients infected with severe acute respiratory syndrome coronavirus 2 requiring venovenous extracorporeal membrane oxygenation. The secondary objective was to compare venous thromboembolism events and coagula...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000004504

    authors: Parzy G,Daviet F,Puech B,Sylvestre A,Guervilly C,Porto A,Hraiech S,Chaumoitre K,Papazian L,Forel JM

    更新日期:2020-10-01 00:00:00

  • An unseen danger: frequency of posterior vessel wall penetration by needles during attempts to place internal jugular vein central catheters using ultrasound guidance.

    abstract:OBJECTIVES:To evaluate the frequency of unsuspected posterior vessel wall penetration of the internal jugular vein during ultrasound-guided needle cannulation. DESIGN:Prospective, single-blinded observational study. SETTING:Urban level I emergency department with an annual census of 80,000. PATIENTS:Residents who ha...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e3181a067d4

    authors: Blaivas M,Adhikari S

    更新日期:2009-08-01 00:00:00

  • Propranolol blocks cocaine-induced cerebral vasodilation in newborn sheep.

    abstract:OBJECTIVE:The objective of this study was to test the hypothesis that cocaine-induced cerebral vasodilation in newborn sheep is mediated via beta-adrenergic receptor activation. DESIGN:The cerebral effects of a single intravenous injection of cocaine (4 mg/kg) given 30 mins after pretreatment with propranolol (1 mg/kg...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199904000-00036

    authors: O'Brien TP,Pane MA,Traystman RJ,Gleason CA

    更新日期:1999-04-01 00:00:00

  • Reliability of point-of-care testing for glucose measurement in critically ill adults.

    abstract:BACKGROUND:Glycemic control is increasingly being recognized as a priority in the treatment of critically ill patients. Titration and monitoring of insulin infusions involve frequent blood glucose measurement to achieve target glucose ranges and prevent adverse events related to hypoglycemia. Therefore, it is imperativ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.ccm.0000189939.10881.60

    authors: Kanji S,Buffie J,Hutton B,Bunting PS,Singh A,McDonald K,Fergusson D,McIntyre LA,Hebert PC

    更新日期:2005-12-01 00:00:00

  • Impact of adequate empirical antibiotic therapy on the outcome of patients admitted to the intensive care unit with sepsis.

    abstract:OBJECTIVES:Our primary goal was to evaluate the impact on in-hospital mortality rate of adequate empirical antibiotic therapy, after controlling for confounding variables, in a cohort of patients admitted to the intensive care unit (ICU) with sepsis. The impact of adequate empirical antibiotic therapy on early (<3 days...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000098031.24329.10

    authors: Garnacho-Montero J,Garcia-Garmendia JL,Barrero-Almodovar A,Jimenez-Jimenez FJ,Perez-Paredes C,Ortiz-Leyba C

    更新日期:2003-12-01 00:00:00

  • The lectin-like domain of tumor necrosis factor improves lung function after rat lung transplantation--potential role for a reduction in reactive oxygen species generation.

    abstract:OBJECTIVE:To test the hypothesis that the lectin-like domain of tumor necrosis factor, mimicked by the TIP peptide, can improve lung function after unilateral orthotopic lung isotransplantation. Because of a lack of a specific treatment for ischemia reperfusion-mediated lung injury, accompanied by a disrupted barrier i...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e3181cdf725

    authors: Hamacher J,Stammberger U,Roux J,Kumar S,Yang G,Xiong C,Schmid RA,Fakin RM,Chakraborty T,Hossain HM,Pittet JF,Wendel A,Black SM,Lucas R

    更新日期:2010-03-01 00:00:00

  • High-frequency jet ventilation in weaning the ventilator-dependent patient.

    abstract::Nine ventilator-dependent patients were successfully weaned from mechanical ventilatory support by high-frequency jet ventilation. All patients had been on ventilatory support for at least 2 wk, and had not responded to attempts at weaning by intermittent mandatory ventilation. ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198409000-00021

    authors: Klain M,Kalla R,Sladen A,Guntupalli K

    更新日期:1984-09-01 00:00:00

  • Intestinal ischemia/reperfusion enhances microglial activation and induces cerebral injury and memory dysfunction in rats.

    abstract:OBJECTIVE:The mortality of critically ill patients associated with intestinal ischemia/reperfusion remains very high, which results from multiorgan dysfunction or failure due to intestinal injury induced by intestinal ischemia/reperfusion. This study was carried out to investigate whether intestinal ischemia/reperfusio...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e3182546855

    authors: Zhou J,Huang WQ,Li C,Wu GY,Li YS,Wen SH,Lei WL,Liu KX

    更新日期:2012-08-01 00:00:00

  • The family conference as a focus to improve communication about end-of-life care in the intensive care unit: opportunities for improvement.

    abstract::The intensive care unit (ICU) represents a hospital setting in which death and discussion about end-of-life care are common, yet these conversations are often difficult. Such difficulties arise, in part, because a family may be facing an unexpected poor prognosis associated with an acute illness or exacerbation and, i...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00003246-200102001-00006

    authors: Curtis JR,Patrick DL,Shannon SE,Treece PD,Engelberg RA,Rubenfeld GD

    更新日期:2001-02-01 00:00:00

  • Distinct pathways of lipopolysaccharide priming of human neutrophil respiratory burst: role of lipid mediator synthesis and sensitivity to interleukin-10.

    abstract:OBJECTIVE:Exposure of neutrophils to low doses of bacterial lipopolysaccharides enhances their readiness to respond with inflammatory mediator generation including oxygen radical formation to a subsequently applied inflammatory stimulus ("priming"). In the present study, we investigated the role of lipid mediator synth...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-200210000-00020

    authors: Sibelius U,Hattar K,Hoffmann S,Mayer K,Grandel U,Schenkel A,Seeger W,Grimminger F

    更新日期:2002-10-01 00:00:00

  • External Corroboration That Corticosteroids May Be Harmful to Septic Shock Endotype A Patients.

    abstract:OBJECTIVES:We previously reported gene expression-based endotypes of pediatric septic shock, endotypes A and B, and that corticosteroid exposure was independently associated with increased mortality among pediatric endotype A patients. The Vasopressin vs Norepinephrine as Initial Therapy in Septic Shock trial tested th...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000004709

    authors: Wong HR,Hart KW,Lindsell CJ,Sweeney TE

    更新日期:2021-01-01 00:00:00

  • A method for predicting survival and mortality of ICU patients using objectively derived weights.

    abstract::Data at ICU admission and after 24 h in the ICU were collected on 755 patients, to derive multiple logistic regression models for predicting hospital mortality. The derived models contained relatively few and easily obtained variables. The weight associated with each variable was determined objectively. There were sev...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198507000-00001

    authors: Lemeshow S,Teres D,Pastides H,Avrunin JS,Steingrub JS

    更新日期:1985-07-01 00:00:00

  • Keratinocyte growth factor and hepatocyte growth factor in bronchoalveolar lavage fluid in acute respiratory distress syndrome patients.

    abstract:OBJECTIVES:To determine bronchoalveolar lavage (BAL) fluid concentrations of keratinocyte growth factor (KGF) and hepatocyte growth factor (HGF), two potent growth factors for alveolar type II epithelial cells, in patients with acute respiratory distress syndrome (ARDS). DESIGN:Prospective study. SETTING:An adult tra...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-200007000-00024

    authors: Stern JB,Fierobe L,Paugam C,Rolland C,Dehoux M,Petiet A,Dombret MC,Mantz J,Aubier M,Crestani B

    更新日期:2000-07-01 00:00:00

  • Urea removal during continuous hemodiafiltration.

    abstract:OBJECTIVE:To compare urea nitrogen removal by continuous hemodiafiltration vs. functional native kidneys in critically ill, septic patients receiving > 2 g of amino acids/kg body weight per day. DESIGN:Prospective, comparative, unblinded study. SETTING:Trauma critical care units of a Level I adult trauma hospital. P...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199403000-00009

    authors: Frankenfield DC,Reynolds HN,Wiles CE 3rd,Badellino MM,Siegel JH

    更新日期:1994-03-01 00:00:00