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6. Managing the Chronically Ventilated Critically Ill Population.

Author

Chichra, Astha, Tickoo, Mayanka, and Honiden, Shyoko

Subjects
*CRITICALLY ill, *INTENSIVE care units, *CATASTROPHIC illness, *ARTIFICIAL respiration, *PALLIATIVE treatment
Abstract

Advances in intensive care over the past few decades have significantly improved the chances of survival for patients with acute critical illness. However, this progress has also led to a growing population of patients who are dependent on intensive care therapies, including prolonged mechanical ventilation (PMV), after the initial acute period of critical illness. These patients are referred to as the "chronically critically ill" (CCI). CCI is a syndrome characterized by prolonged mechanical ventilation, myoneuropathies, neuroendocrine disorders, nutritional deficiencies, cognitive and psychiatric issues, and increased susceptibility to infections. It is associated with high morbidity and mortality as well as a significant increase in healthcare costs. In this article, we will review disease burden, outcomes, psychiatric effects, nutritional and ventilator weaning strategies as well as the role of palliative care for CCI with a specific focus on those requiring PMV. [ABSTRACT FROM AUTHOR]

Published
2024
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15. A clinic blueprint for post-COVID-19 RECOVERY: Learning from the past, looking to the future

Author

Lutchmansingh, Denyse D., Knauert, Melissa P., Antin-Ozerkis, Danielle E., Chupp, Geoffrey, Cohn, Lauren, Dela Cruz, Charles S., Ferrante, Lauren E., Herzog, Erica L., Koff, Jonathan, Rochester, Carolyn L., Ryu, Changwan, Singh, Inderjit, Tickoo, Mayanka, Winks, Vikki, Gulati, Mridu, and Possick, Jennifer D.

Subjects
Critical Care, SARS-CoV-2, Rehabilitation Research, Risk Factors, CHEST Reviews, Critical Illness, Post COVID-19 programs, Interdisciplinary Research, Multidisciplinary clinic design, COVID-19, Humans, Outcomes, Recovery of Function
Abstract

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic poses extraordinary challenges. The tremendous number of coronavirus disease 2019 (COVID-19) cases in the United States has resulted in a large population of survivors with prolonged post-infectious symptoms. The creation of multidisciplinary post-COVID-19 clinics to address both persistent symptoms and potential long-term complications requires an understanding of the acute disease and the emerging data regarding COVID-19 outcomes. Experience with severe acute respiratory syndrome and Middle East respiratory syndrome, post-acute respiratory distress syndrome complications, and post-intensive care syndrome also informs anticipated sequelae and clinical program design. Post-COVID-19 clinical programs should be prepared to care for individuals previously hospitalized with COVID-19 (including those who required critical care support), non-hospitalized individuals with persistent respiratory symptoms following COVID-19 infection, and individuals with pre-existing lung disease complicated by COVID-19. Effective multidisciplinary collaboration models leverage lessons learned during the early phases of the pandemic to overcome the unique logistical challenges posed by pandemic circumstances. Collaboration between clinicians and researchers across disciplines will provide insight into survivorship that may shape the treatment of both acute disease and chronic complications. In this review, we discuss the aims, general principles, elements of design, and challenges of a successful multidisciplinary model to address the needs of COVID-19 survivors.

Published
2020

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