Clinical Pearls

Abstract

Long-term cognitive, psychological, and physical sequelae can occur in patients after a critical illness and are collectively termed post–intensive care syndrome (PICS). Given the various symptoms that may occur, assessing for PICS is difficult and the syndrome can often go unrecognized.Wang and colleagues tested the use of a clinical tool that captures all 3 domains of PICS, called the Healthy Aging Brain Care Monitor Self Report (HABC-M SR), with adult patients in a critical care recovery center (CRRC). They found the following:The authors recommend that clinicians consider neuropsychological testing in younger intensive care unit survivor patients. Although future studies are needed, the HABC-M SR is a short and easy-to-use tool for assessing PICS symptoms.See Article, pp 10-18It is well known that a critical care hospitalization is stressful for patients, causing symptoms of anxiety, depression, posttraumatic stress, and several physiological sequelae. Music listening has been used as a non-pharmacological intervention, but research findings have been varied. Few music therapy studies have involved patients in intensive care units.Golino and colleagues examined the use of active music therapy provided by a board-certified music therapist. Patients were assigned to 1 of 2 interventions: live music chosen for relaxation or a song chosen for its meaning. The researchers found the following:Although further research is needed to evaluate timing and dose of music therapy, the findings support the presence of a music therapist in the intensive care unit to modify music interventions to individual patients’ needs.See Article, pp 48-55Thirst and dry mouth are uncomfortable and distressing symptoms common to many patients in intensive care units and occur for a variety of reasons such as use of mechanical ventilation, receiving specific types of medications, and receiving nothing by mouth. However, neither symptom is routinely assessed or treated.VonStein and colleagues compared the use of ice water oral swabs and lip moisturizer with menthol as a treatment in 2 groups of patients—those receiving the treatment on an hourly schedule and those with unscheduled use as needed. They found the following:Use of ice water oral swabs and lip moisturizers is a simple intervention that can be added to routine patient care. The authors recommend engaging patients and their family members in the treatment regime for more active involvement in the plan of care.See Article, pp 41-46Post–intensive care syndrome (PICS) is an umbrella term used to describe symptoms such as anxiety, depression, and posttraumatic stress disorder. PICS has been identified in both critical care patients and their families. Although efforts to educate families of adult patients have been studied, little research has been focused on parents of critically ill children.Esses and colleagues compared 3 education strategies—brochure, video, or scripted conversation—to improve the knowledge of PICS with parents in the pediatric intensive care unit. They found the following:Brochures are a tangible, low-cost resource that families can refer to throughout their child’s hospital stay and after discharge.See Article, pp 19-27