Depressive symptoms and anxiety in intensive care unit (ICU) survivors after ICU discharge

Choi, Jae Shi; Tate, Judith A.; Rogers, Mary Alana; Donahoe, Michael P.; Hoffman, Leslie A.

doi:10.1016/j.hrtlng.2015.12.002

Cited by 39 publications

(24 citation statements)

References 54 publications

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“…Specifically, studies show that 75% of patients discharged from the ICU exhibit lasting symptoms of dementia, anxiety, or depression (10). Notably, this public health crisis spans all socioeconomic classes, genders, ethnicities, and genetic predispositions (11,12).…”

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confidence: 99%

Infection‐induced endothelial amyloids impair memory

et al. 2019

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Patients with nosocomial pneumonia exhibit elevated levels of neurotoxic amyloid and tau proteins in the cerebrospinal fluid (CSF). In vitro studies indicate that pulmonary endothelium infected with clinical isolates of either Pseudomonas aeruginosa, Klebsiella pneumoniae, or Staphylococcus aureus produces and releases cytotoxic amyloid and tau proteins. However, the effects of the pulmonary endothelium‐derived amyloid and tau proteins on brain function have not been elucidated. Here, we show that P. aeruginosa infection elicits accumulation of detergent insoluble tau protein in the mouse brain and inhibits synaptic plasticity. Mice receiving endothelium‐derived amyloid and tau proteins via intracerebroventricular injection exhibit a learning and memory deficit in object recognition, fear conditioning, and Morris water maze studies. We compared endothelial supernatants obtained after the endothelia were infected with P. aeruginosa possessing an intact [P. aeruginosa isolated from patient 103 (PA103) supernatant] or defective [mutant strain of P. aeruginosa lacking a functional type 3 secretion system needle tip complex (ΔPcrV) supernatant] type 3 secretion system. Whereas the PA103 supernatant impaired working memory, the ΔPcrV supernatant had no effect. Immunodepleting amyloid or tau proteins from the PA103 supernatant with the A11 or T22 antibodies, respectively, overtly rescued working memory. Recordings from hippocampal slices treated with endothelial supernatants or CSF from patients with or without nosocomial pneumonia indicated that endothelium‐derived neurotoxins disrupted the postsynaptic synaptic response. Taken together, these results establish a plausible mechanism for the neurologic sequelae consequent to nosocomial bacterial pneumonia.—Balczon, R., Pittet, J.‐F., Wagener, B. M., Moser, S. A., Voth, S., Vorhees, C. V., Williams, M. T., Bridges, J. P., Alvarez, D. F., Koloteva, A., Xu, Y., Zha, X.‐M., Audia, J. P., Stevens, T., Lin, M. T. Infection‐induced endothelial amyloids impair memory. FASEB J. 33, 10300–10314 (2019). http://www.fasebj.org

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confidence: 99%

Infection‐induced endothelial amyloids impair memory

et al. 2019

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“…Intensive care units (ICUs) are highly complex, comprise many biomedical devices, and utilize numerous treatment methods with a multidisciplinary team approach . Although these units provide invaluable benefits in treatment and care, patients in ICUs face many stressors . Any stress or conditions requiring physical or psychological adaptation, that is, a threat or difficulty, are considered stressors .…”

Section: Introductionmentioning

confidence: 99%

“…1 Although these units provide invaluable benefits in treatment and care, patients in ICUs face many stressors. 2,3 Any stress or conditions requiring physical or psychological adaptation, that is, a threat or difficulty, are considered stressors. 4 Stressors in ICUs can be divided into two categories, physical/environmental and psychological, and they can be because of surgery or medical treatment, relationships with health staff, or the ICU environment.…”

Section: Introductionmentioning

confidence: 99%

The relationship between stressors and intensive care unit experiences

Zengin¹,

Ören²,

Ustundag

2019

Nursing in Critical Care

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Background Patients in intensive care units (ICUs) face many physical and psychological stressors because of the environment of these units and their own critical conditions and experience stress in various degrees. Each stressor may affect patients' experiences in ICUs differently. Aim and objectives This study aimed to examine the relationship between stressors and patients' experiences in an ICU. Methods This descriptive, cross‐sectional study was conducted between September 2014 and June 2015 in a university hospital and included 116 patients who were admitted to the general ICU for at least 24 hours. Data were collected using the Intensive Care Experience Scale and a questionnaire that included questions about socio‐demographic and disease‐related characteristics of patients and their stressors. Results The mean age of the patients was 57.81 ± 13.81 years, and the mean duration of ICU stay was 2.28 ± 3.88 days. There was a moderate positive relation between the stressors noise (r = .534; P < .01), thirst (r = .438; P < .01), loneliness (r = .410; P < .01), and pain (r = .404; P < .01) and the subscale frightening experiences. However, there was a moderate, negative relation between the stressors inability to speak (r = −.444; P < .01), surrounding speeches (r = −.458; P < .01), equipment noise (r = −.490; P < .01), and physical exercise (r = −.546; P < .01) and the subscale satisfaction with care. Conclusions The patients associated stressors with satisfaction and frightening experiences in the early period of their discharge from the ICU. As stressors increases, so do frightening experiences, and satisfaction with care is affected negatively. Relevance to clinical practice Currently, stressors to which patients discharged from ICU are exposed during their admission to wards are not evaluated in practice. This study is important in that it can help health professionals be aware of effects of stressors on patients in the early period of their discharge.

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“…Specifically, individuals with PICS experience some or all of the following: physical problems including reduced pulmonary functioning, 13 muscular weakness, 5 limited function such as walking 14 and difficulty returning to work; 15 mental health disorders including anxiety/acute stress disorder, 16 post-traumatic stress disorder 17 and depression; 18 cognitive impairments, including disruption of executive function, memory and mental processing speed. 19 …”

Section: Introductionmentioning

confidence: 99%

“…mental health disorders including anxiety/acute stress disorder, 16 post-traumatic stress disorder 17 and depression; 18 …”

Section: Introductionmentioning

confidence: 99%

Impairments, activity limitations and participation restrictions experienced in the first year following a critical illness: protocol for a systematic review

et al. 2017

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IntroductionCritical illness requiring intensive care unit (ICU) management is a life-altering event with ∼25% of ICU survivors experiencing persistent reductions in physical functioning, impairments in mental health, cognitive dysfunction and decreased quality of life. This constellation of problems is known as ‘postintensive care syndrome’ (PICS) and may persist for months and/or years. The purpose of this systematic review is to identify the scope and magnitude of physical problems associated with PICS during the first year after discharge from ICU, using the International Classification of Functioning, Disability and Health framework to elucidate the impairments of body functions and structures, activity limitations and participation restrictions.Methods and analysisMedline (Ovid), Cochrane Database of Systematic Reviews (Ovid), Cochrane Central Register of Controlled Trials (Ovid), PubMed, CINAHL (EBSCO), Web of Science and EMBASE will be systematically searched for observational studies reporting the physical impairments of body functions and structures, activity limitations and participation restrictions associated with PICS. Two reviewers will assess the articles for eligibility according to prespecified selection criteria, after which an independent reviewer will perform data extraction which will be validated by a second independent reviewer. Quality appraisal will be performed by two independent reviewers. Outcomes of the included studies will be summarised in tables and in narrative format and meta-analyses will be conducted where appropriate.Ethics and disseminationFormal ethical approval is not required as no primary data is collected. This systematic review will identify the scope and magnitude of physical problems associated with PICS during the first year after discharge from ICU and will be disseminated through a peer-reviewed publication and at conference meetings, to inform practice and future research on the physical problems associated with PICS.Trial registration numberCRD42015023520.

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Depressive symptoms and anxiety in intensive care unit (ICU) survivors after ICU discharge

Cited by 39 publications

References 54 publications

Infection‐induced endothelial amyloids impair memory

Infection‐induced endothelial amyloids impair memory

The relationship between stressors and intensive care unit experiences

Impairments, activity limitations and participation restrictions experienced in the first year following a critical illness: protocol for a systematic review

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