1,721,010 research outputs found
Outcomes among Patients with 1-Year Survival after Intensive Care Unit Treatment for COVID-19
No full textLong-term complications of COVID-19 in ICU survivors: What do we know?
Full text linkCoronavirus disease 2019 (COVID-19) has caused more than 175 million persons infected and 3.8 million deaths so far and is having a devastating impact on both low and high-income countries, in particular on hospitals and Intensive Care Units (ICU). The ICU mortality during the first pandemic wave ranged from 40% to 85% during the busiest ICU period for admissions around the peak of the surge, and those surviving are frequently faced with impairments affecting physical, cognitive, and mental health status, complicating the postacute phase of COVID-19, which in the pre-COVID period, were defined collectively as postintensive care syndrome (PICS). Long COVID is defined as four weeks of persisting symptoms after the acute illness, and post-COVID syndrome and chronic COVID-19 are the proposed terms to describe continued symptomatology for more than 12 weeks. Overall, 50% of ICU survivors suffer from new physical, mental, and/or cognitive problems at 1 year after ICU discharge. The prevalence, severity, and duration of the various impairments in ICU survivors are poorly defined, with substantial variations among published series, and may reflect differences in the timing of assessment, the outcome measured, the instruments utilized, and thresholds adopted to establish the diagnosis, the qualification of personnel delivering the tests, the resource availability as well diversity in patients' case-mix. Future longitudinal studies of adequate sample size with repeated assessments of validated outcomes and comparison with non-COVID-19 ICU patients are needed to fully explore the long-term outcome of ICU patients with COVID-19. In this article, we focus on chronic COVID-19 in ICU survivors and present state-of-the-art data regarding long-term complications related to critical illness and the treatments and organ support received
Letter by Castioni et al regarding article, "general anesthesia versus conscious sedation and local anesthesia during thrombectomy for acute ischemic stroke"
No full text
Following Up the Patients at Long Term
No full textThe post-intensive care syndrome (PICS) is a major health problem which impairs the quality of life of patients surviving an acute illness and that of their families and has a huge impact on the whole society. With decreasing ICU mortality observed in the last decades, the number of surviving patients is anticipated to increase, as is the number of those surviving with long-lasting severe functional, cognitive, and mental health impairments. The list of symptoms and signs affecting patients surviving the critical illness is continuously updated, and it is a safe bet that PICS will soon need to widen its definition to include new conditions. The critical care community should consider it a great priority to prepare the future generations of intensivists not only to save lives but also to take charge of PICS. This chapter describes a model to follow-up patients surviving an acute illness with a comprehensive clinical approach and reviews the most relevant clinical characteristics of PICS, the risk factors for post-ICU impairments and the strategies for their timely detection
Delirium: lost in connection
No full textComment on:
The relationship between delirium duration, white matter integrity, and cognitive impairment in intensive care unit survivors as determined by diffusion tensor imaging: the VISIONS prospective cohort magnetic resonance imaging study*. [Crit Care Med. 2012
The pathophysiology of propofol infusion syndrome: A simple name for a complex syndrome
No full textPropofol infusion syndrome (PRIS) is a rare and often fatal syndrome described in critically ill children undergoing long-term propofol infusion at high doses. Recently several cases have been reported in adults, too. The main features of the syndrome consist of cardiac failure, rhabdomyolysis, severe metabolic acidosis and renal failure. To date 21 paediatric cases and 14 adult cases have been described. These latter were mostly patients with acute neurological illnesses or acute inflammatory diseases complicated by severe infections or even sepsis, and receiving catecholamines and/or steroids in addition to propofol. Central nervous system activation with production of catecholamines and glucocorticoids, and systemic inflammation with cytokine production are priming factors for cardiac and peripheral muscle dysfunction. High-dose propofol, but also supportive treatments with catecholamines and corticosteroids, act as triggering factors. At the subcellular level, propofol impairs free fatty acid utilisation and mitochondrial activity. Imbalance between energy demand and utilisation is a key pathogenetic mechanism, which may lead to cardiac and peripheral muscle necrosis. Propofol infusion syndrome is multifactorial, and propofol, particularly when combined with catecholamines and/or steroids, acts as a triggering factor. The syndrome can be lethal and we suggest caution when using prolonged (>48 h) propofol sedation at doses higher than 5 mg/kg per h, particularly in patients with acute neurological or inflammatory illnesses. In these cases, alternative sedative agents should be considered. If unsuitable, strict monitoring of signs of myocytolysis is advisable
Publisher Correction to: Critical Illness Weakness, Polyneuropathy and Myopathy: Diagnosis, treatment, and long‐term outcomes (Critical Care, (2023), 27, 1, (439), 10.1186/s13054-023-04676-3)
No full textFollowing publication of the original article [1], an incomplete title was published. The word ‘Critical’ was missing from the title. The incorrect title is: Illness Weakness, Polyneuropathy and Myopathy: Diagnosis, treatment, and long-term outcomes The correct title is: Critical Illness Weakness, Polyneuropathy and Myopathy: Diagnosis, treatment, and long‐term outcomes The publisher sincerely apologize to the authors and readers for the inconvenience caused. The title has been updated in this publisher correction and the original article [1] has been corrected
- …
