Articles: intensive-care-units.
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Critical care clinics · Jan 2025
ReviewIntegrating Compassion and Collaboration into the Care of Intensive Care Unit Survivors: A Modest Proposal.
The number of intensive care unit (ICU) survivors continues to grow, largely due to the emergence of more sophisticated treatment options. Yet despite this remarkable life-saving progress, far too little attention is paid to the survivor's long-term quality of life after discharge. Post-Intensive Care Syndrome continues to impact many survivors' physical, cognitive, and mental health, as well as their social functioning related to these new impairments. In light of this knowledge, there is room to enhance compassionate care, both in and after the ICU, starting with improved collaboration with the patient, their caregivers, and other providers on the patient's care team.
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Pediatr Crit Care Me · Jan 2025
Multicenter Study Observational StudyMechanical Thromboprophylaxis and Hospital-Acquired Venous Thromboembolism Among Critically Ill Adolescents: A U.S. Pediatric Health Information Systems Registry Study, 2016-2023.
To estimate the rate of mechanical thromboprophylaxis (mTP) prescription among critically ill adolescents using a multicenter administrative database and determine whether mTP prescription is inversely associated with hospital-acquired venous thromboembolism. ⋯ In the multicenter PHIS cohort, 2016-2023, the prescribing patterns for mTP among critically ill adolescents showed a low rate of mTP prescription (19.6%) that varied widely across institutions, decreased annually over the study period by 1.6%/year, and was not independently associated with HA-VTE risk reduction.
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Intensive care medicine · Jan 2025
Multicenter Study Observational StudyLeft ventricular diastolic dysfunction is prevalent but not associated with mortality in patients with septic shock.
Prognostic impact of left ventricular diastolic dysfunction (LVDD) in septic shock patients has not been determined using current diagnostic guidelines. We assessed the relation between LVDD during the first 3 days following intensive care unit (ICU) admission for septic shock and Day-28 mortality. ⋯ LVDD was highly prevalent in patients with septic shock but not associated with mortality. It appeared improving in one-third of survivors.
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Status epilepticus is a common neurological emergency that is characterised by prolonged or recurrent seizures without recovery between episodes and associated with substantial morbidity and mortality. Prompt recognition and targeted therapy can reduce the risk of complications and death associated with status epilepticus, thereby improving outcomes. The most recent International League Against Epilepsy definition considers two important timepoints in status epilepticus: first, when the seizure does not self-terminate; and second, when the seizure can have long-term consequences, including neuronal injury. ⋯ If status epilepticus continues, management should entail second-line and third-line treatment agents, supportive EEG monitoring, and admission to an intensive care unit. Future research to study early seizure detection, rescue protocols and medications, rapid treatment escalation, and integration of fundamental scientific and clinical evidence into clinical practice could shorten seizure duration and reduce associated complications. Furthermore, improved recognition, education, and treatment in patients who are at risk might help to prevent status epilepticus, particularly for patients living in low-income and middle-income countries.
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This review explores the financial consequences that survivors of critical illness often face following hospitalization in an intensive care unit (ICU). As part of the "post-intensive care syndrome" (PICS), these survivors often experience, in addition to physical and emotional challenges of PICS, major financial burdens resulting from their prolonged ICU treatments. The escalating costs of ICU care, coupled with the potential long-term effects on survivors' ability to work and maintain financial stability, have brought financial toxicity to the forefront of health care discussions. The current review examines the causes and consequences of financial toxicity.