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