Humanizing interventions in the ICU for patients at risk for post intensive care syndrome: protocol of a multicentered, clinical trial

Abstract

The ICU is an extremely relevant unit in the hospital, its main function is to help patients in a critical situation and to prevent any life-threatening complications.

Patients from the ICU can be planned or unexpected, can come from various places, and can require different treatments depending on their issues. The main pillars for admission in the ICU are hemodynamic instability, pulmonary dysfunction, neurological disease, complicated post-op recovery and polytrauma patients.

Although ICU patients may have serious conditions, 90% of patients survive and move past it. However, the invasive treatments and measures can often affect patients causing mental, physical, and cognitive issues, this is known as the Post-Intensive Care Syndrome (PICS). It was first named as an entity in 2010 by the Society of Critical Care Medicine. And, according to different studies, PICS can affect from 30 to 50%, or more, of patients after ICU.

PICS main symptoms are muscle weakness, myopathy, loss of attention, slow speech, impaired executive functions and finally symptoms of depression, anxiety and Post Traumatic Stress Disorder (PTSD) with flashbacks from the ICU stay. These symptoms can appear a few months after discharge and last up to six years after it, particularly for cognitive symptoms. Affecting patients quality of life after the critical ward.

Similarly, PICS does not only affect patients but family relatives too, this is known as the PICS- F, especially depression, anxiety and possibly even PTSD.

However there have been some measures that have been developed, but they are still in their infancy. This is why the aim of this project is to prove that different humanizing measures can help prevent PICS and therefore improve patients quality of life after ICU discharge