Post-intensive Care Syndrome & Chronic Critical Illness, An Issue of Critical Care Clinics, Volume 34-4

This issue of Critical Care Clinics focuses on Post-intensive Care Syndrome & Chronic Critical Illness, with topics including: Chronic Critical Illness; Chronic Critical Illness and Predicting Outcomes; Persistent Critical Illness; Rehospitalization and Preventing CCI; Measuring Post-Intensive Care Syndrome; Post-Intensive Care Syndrome and teh Role of the ICU Clinician; Frailty and the Association between Long-Term Recovery After ICU; The Role of the Muscles in Post-Intensive Care Syndrome; Intensive Care Nutrition and Post-Intensive Care Recovery; Early mobilization in the ICU to Improve Long Term Recovery; The Use of Sedation in the ICU and Long-Term Outcomes; Cognitive Function after Critical Illness; Anxiety and Depression after ICU; and Family and Support Networks after ICU.

· Section 1: Chronic Critical Illness

· Patient and Population-Level Approaches to Persistent Critical Illness and Prolonged Intensive Care Unit Stays

· Key points

· The epidemiology of long stays in the intensive care unit

· Patient-level differential diagnosis

· Population impact

· Implications of a persistent critical illness framework

· Preventing Chronic Critical Illness and Rehospitalization: A Focus on Sepsis

· Key points

· Introduction

· Medical setbacks and hospital readmission

· Prevention, mitigation, and rehabilitation strategies

· Summary

· Section 2: Post-Intensive Care Syndrome

· Measuring Outcomes After Critical Illness

· Key points

· Introduction

· Outcome domains after critical illness

· Functional status

· Linking diseases with impairments and disabilities

· Summary

· Frailty and the Association Between Long-Term Recovery After Intensive Care Unit Admission

· Key points

· Introduction to frailty

· Pathophysiology of frailty

· Measurement of frailty

· Frailty and critical illness

· Outcomes of frailty in critical illness

· Strategies and interventions

· Addressing knowledge gaps with future work

· Summary

· The Pathophysiology of Neuromuscular Dysfunction in Critical Illness

· Key points

· Introduction

· The condition

· Risk factors

· Mechanisms

· Time frame

· Summary

· Early Mobilization in the Intensive Care Unit to Improve Long-Term Recovery

· Key points

· Introduction

· Summary

· Intensive Care Nutrition and Post–Intensive Care Recovery

· Key points

· Introduction

· To feed or not to feed?

· Is early supplementation of insufficient enteral nutrition with parenteral nutrition beneficial?

· Is early enteral nutrition better than early parenteral nutrition?

· Is early full enteral nutrition beneficial?

· Do high doses of amino acids provide benefit?

· Is indirect calorimetry–based feeding superior to calculation-based feeding?

· Is there a role of adding immunonutrients?

· Mechanisms explaining the absence of a benefit of early full feeding

· Nutrition during recovery and after intensive care unit stay

· Summary

· Sedation, Delirium, and Cognitive Function After Critical Illness

· Key points

· Introduction

· Sedation during critical illness

· Delirium during critical illness

· Cognition after critical illness

· Summary

· Psychiatric Morbidity After Critical Illness

· Key points

· What is meant by psychiatric morbidity?

· How is psychiatric morbidity measured?

· Why is psychiatric morbidity relevant to critical illness?

· How often do critical illness survivors develop psychiatric morbidity?

· Which patient factors are associated with psychiatric morbidity after critical illness?

· What intensive care unit and early postintensive care unit factors are associated with later psychiatric morbidity?

· Which interventions are effective in decreasing postcritical illness psychiatric morbidity?

· What if patients have substantial psychiatric morbidity at follow-up visits?

· Summary

· Family and Support Networks Following Critical Illness

· Key points

· Introduction

· Psychosocial outcomes of informal caregivers across the care arc

· Outcome measurement

· Interventional research to improve caregiver psychosocial outcomes

· Innovative approaches to rapidly build social support networks