Fatigue of ICU Survivors, No Longer to Be Neglected

Spadaro, Savino; Capuzzo, Maurizia; Volta, Carlo Alberto

doi:10.1016/j.chest.2020.05.521

Cited by 5 publications

(4 citation statements)

References 12 publications

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“…Malnutrition is also frequent in ICU patients. Further research is needed to evaluate to what point malnutrition and other risk factors, such as the level of social integration for instance, can worsen fatigue, and whether the use of optimal care, or optimized nutrition may alleviate fatigue 38 .…”

Section: Discussionmentioning

confidence: 99%

Prevalence of self-reported fatigue in intensive care unit survivors 6 months–5 years after discharge

Morel

Infantino

Gergelé

et al. 2022

Sci Rep

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Prolonged stays in intensive care units (ICU) are responsible for long-lasting consequences, fatigue being one of the more debilitating. Yet, fatigue prevalence for patients that have experienced ICU stays remains poorly investigated. This study aimed to evaluate fatigue prevalence and the level of physical activity in ICU survivors from 6 months to 5 years after ICU discharge using the Functional Assessment of Chronic Illness Therapy Fatigue (FACIT-F) and Godin questionnaires, respectively. Data from 351 ICU survivors (out of 1583 contacted) showed that 199 (57%) and 152 (43%) were considered as fatigued and non-fatigued, respectively. The median FACIT-F scores for fatigued versus non-fatigued ICU survivors were 21 (14–27) and 45 (41–48), respectively (p < 0.001). Time from discharge had no significant effect on fatigue prevalence (p = 0.30) and fatigued ICU survivors are less active (p < 0.001). In multivariate analysis, the only risk factor of being fatigued that was identified was being female. We reported a high prevalence of fatigue among ICU survivors. Sex was the only independent risk factor of being fatigued, with females being more prone to this symptom. Further studies should consider experimental approaches that help us understand the objective causes of fatigue, and to build targeted fatigue management interventions.

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Section: Discussionmentioning

confidence: 99%

Prevalence of self-reported fatigue in intensive care unit survivors 6 months–5 years after discharge

Morel

Infantino

Gergelé

et al. 2022

Sci Rep

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“…Furthermore, subjective cognitive complaints may be driven more by psychiatric symptoms and expectations rather than actual underlying neuropathology. Additionally, at least in the intermediate-term postacute phase, individuals who undergo ICU treatment and experience severe medical complications such as respiratory failure or neurologic insult can be fatigued, irritable, anxious, and/or depressed, which also overlap with the non-cognitive clinical symptoms of PTSD (Dolan et al, 2012;Spadaro et al, 2020). Assessment of other specific ICU-related factors which have been linked to cognitive outcomes, such as recall of ICU treatment, experience of delirium, and use of sedatives and analgesics, may be an informative addition to the clinical interview (Jackson et al, 2009).…”

Section: Recommendations For the Neuropsychological Assessment Of Covid-19 Survivors With Psychological Traumamentioning

confidence: 99%

Post-traumatic stress disorder: A differential diagnostic consideration for COVID-19 survivors

Kaseda

Levine

2020

The Clinical Neuropsychologist

146

116

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Objective: SARS-CoV-2 infection and its oft-associated illness COVID-19 may lead to neuropsychological deficits, either through direct mechanisms (i.e., neurovirulance) or indirect mechanisms, most notably complications caused by the virus (e.g., stroke) or medical procedures (e.g., intubation). The history of past human coronavirus outbreaks resulting in similar health emergencies suggests there will be a substantial prevalence of post-traumatic stress disorder (PTSD) among COVID-19 survivors. To prepare neuropsychologists for the difficult task of differentiating PTSD-related from neuropathology-related deficits in the oncoming wave of COVID-19 survivors, we integrate research across a spectrum of related areas. Methods: Several areas of literature were reviewed: psychiatric, neurologic, and neuropathological outcomes of SARS and MERS patients; neurological outcomes in COVID-19 survivors; PTSD associated with procedures common to COVID-19 patients; and differentiating neuropsychological deficits due to PTSD from those due to acquired brain injuries in other patient groups. Conclusions: Heightened risk of PTSD occurred in MERS and SARS survivors. While data concerning COVID-19 is lacking, PTSD is known to occur in patient groups who undergo similar hospital courses, including ICU survivors, patients who are intubated and mechanically ventilated, and those that experience delirium. Research with patients who develop PTSD in the context of mild traumatic brain injury further suggests that PTSD may account for some or all of a patient's subjective cognitive complaints and neuropsychological test performance. Recommendations are provided for assessing PTSD in the context of COVID-19.

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“…The ICU is a specialized hospital department dedicated to the intensive care and treatment of seriously ill patients. The recovery of patients treated in the ICU is crucial for their well-being, as well as for their families and society [ 60 ]. However, ICU patients experience a decline in immunological response and hormone disruption owing to the nature of their illnesses and the risk factors during ICU treatment [ 61 ].…”

Section: Discussionmentioning

confidence: 99%

Non-pharmacological interventions to prevent PICS in critically ill adult patients: a protocol for a systematic review and network meta-analysis

Sun,

Tao,

Cui

et al. 2024

Syst Rev

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Background Postintensive care syndrome (PICS) is common in critically ill adults who were treated in the intensive care unit (ICU). Although comparative analyses between types of non-pharmacological measures and usual care to prevent PICS have been performed, it remains unclear which of these potential treatments is the most effective for prevention. Methods To obtain the best evidence for non-pharmaceutical interventions in preventing PICS, a systematic review and Bayesian network meta-analyses (NMAs) will be conducted by searching nine electronic databases for randomized controlled trials (RCTs). Two reviewers will carefully screen the titles, abstracts, and full-text papers to identify and extract relevant data. Furthermore, the research team will meticulously check the bibliographic references of the selected studies and related reviews to discover any articles pertinent to this research. The primary focus of the study is to examine the prevalence and severity of PICS among critically ill patients admitted to the ICU. The additional outcomes encompass patient satisfaction and adverse effects related to the preventive intervention. The Cochrane Collaboration’s risk-of-bias assessment tool will be utilized to evaluate the risk of bias in the included RCTs. To assess the efficacy of various preventative measures, traditional pairwise meta-analysis and Bayesian NMA will be used. To gauge the confidence in the evidence supporting the results, we will utilize the Confidence in NMA tool. Discussion There are multiple non-pharmacological interventions available for preventing the occurrence and development of PICS. However, most approaches have only been directly compared to standard care, lacking comprehensive evidence and clinical balance. Although the most effective care methods are still unknown, our research will provide valuable evidence for further non-pharmacological interventions and clinical practices aimed at preventing PICS. The research is expected to offer useful data to help healthcare workers and those creating guidelines decide on the most effective path of action for preventing PICS in adult ICU patients. Systematic review registration PROSPERO CRD42023439343. Graphical Abstract

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Fatigue of ICU Survivors, No Longer to Be Neglected

Cited by 5 publications

References 12 publications

Prevalence of self-reported fatigue in intensive care unit survivors 6 months–5 years after discharge

Prevalence of self-reported fatigue in intensive care unit survivors 6 months–5 years after discharge

Post-traumatic stress disorder: A differential diagnostic consideration for COVID-19 survivors

Non-pharmacological interventions to prevent PICS in critically ill adult patients: a protocol for a systematic review and network meta-analysis

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