On September 27 and 28 the Society of Critical Care Medicine (SCCM) held a conference of stakeholders at their headquarters in Chicago, to discuss the problems patients face after a stay in intensive care. In addition to ICU physicians and nurses, physiatrists, psychiatrists, counselors, and representatives of patients and other groups (including palliative care) were invited. I was honored to represent AAHPM.
After a presentation of the evidence to date and some discussion, it became clear that many of us are concerned about the common, often severe, new and worsening impairments of physical, cognitive, and mental health that affect patients and their families following intensive care. Even though it is abundantly clear that their are many likely etiologies and sub-classes, we felt it would be helpful to name this group of disorders Post Intensive Care Syndrome (PICS).
We identified a number of promising approaches, but there are obvious and extensive gaps in our knowledge that require well-designed research studies. Included in these gaps are the needs and outcomes of palliative care patients in the ICU.
We all returned to our home institutions with a deeper knowledge and renewed commitment to raise awareness and do research on the needs and potential treatments for our most vulnerable patients. I am very pleased that hospice and palliative medicine is seen as an important partner in this effort.
Porter Storey
Porter,
Thanks for posting about the SCCM meeting – their interest in palliative care and post-ICSyndrome.
Recent studies suggest that there are some characteristics that seem to correlate with higher risk for PICS that we should pay particular attention to in order to focus or prioritize our services.
Family characteristics: shorter time in relationship with the patient, history of psychiatric disorder, female gender.
Patient characteristics: younger, death while artificially ventilated.
Reference:
doi: 10.1378/chest.10-0652
Kross et al. ICU Care Associated with Symptoms of Depression and PTSD among Family Members of those who Die in the ICU. CHEST September 2010 100652