Exploring the Scope of Post–Intensive Care Syndrome Therapy and Care

医学 重症监护 医疗保健 利益相关者 梅德林 护理部 家庭医学 重症监护医学 政治学 公共关系 经济增长 经济 法学
作者
Doug Elliott,Judy E. Davidson,Maurene A. Harvey,Anita Bemis‐Dougherty,Ramona O. Hopkins,Theodore J. Iwashyna,Jason Wagner,Craig Weinert,Hannah Wunsch,O. Joseph Bienvenu,Gary Black,Susan Brady,Martin B. Brodsky,Cliff Deutschman,Diana Doepp,Carl Flatley,Sue Fosnight,Michelle S. Gittler,Belkys Teresa Gomez,Robert C. Hyzy
出处
期刊:Critical Care Medicine [Lippincott Williams & Wilkins]
卷期号:42 (12): 2518-2526 被引量:375
标识
DOI:10.1097/ccm.0000000000000525
摘要

Increasing numbers of survivors of critical illness are at risk for physical, cognitive, and/or mental health impairments that may persist for months or years after hospital discharge. The post-intensive care syndrome framework encompassing these multidimensional morbidities was developed at the 2010 Society of Critical Care Medicine conference on improving long-term outcomes after critical illness for survivors and their families.To report on engagement with non-critical care providers and survivors during the 2012 Society of Critical Care Medicine post-intensive care syndrome stakeholder conference. Task groups developed strategies and resources required for raising awareness and education, understanding and addressing barriers to clinical practice, and identifying research gaps and resources, aimed at improving patient and family outcomes.Representatives from 21 professional associations or health systems involved in the provision of both critical care and rehabilitation of ICU survivors in the United States and ICU survivors and family members.Stakeholder consensus meeting. Researchers presented summaries on morbidities for survivors and their families, whereas survivors presented their own experiences.Future steps were planned regarding 1) recognizing, preventing, and treating post-intensive care syndrome, 2) building strategies for institutional capacity to support and partner with survivors and families, and 3) understanding and addressing barriers to practice. There was recognition of the need for systematic and frequent assessment for post-intensive care syndrome across the continuum of care, including explicit "functional reconciliation" (assessing gaps between a patient's pre-ICU and current functional ability at all intra- and interinstitutional transitions of care). Future post-intensive care syndrome research topic areas were identified across the continuum of recovery: characterization of at-risk patients (including recognizing risk factors, mechanisms of injury, and optimal screening instruments), prevention and treatment interventions, and outcomes research for patients and families.Raising awareness of post-intensive care syndrome for the public and both critical care and non-critical care clinicians will inform a more coordinated approach to treatment and support during recovery after critical illness. Continued conceptual development and engagement with additional stakeholders is required.
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