Citation

Fernando SM, Ranzani OT, Herridge MS. Intensive Care Med. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s00134-022-06743-9

PMID

35670820

Abstract

Decades of research clearly demonstrate that survivors of critical illness experience substantial morbidity following discharge from the intensive care unit (ICU), collectively referred to as "post-intensive care syndrome" (PICS) [1,2,3]. This includes important downstream mental health morbidity. Initial work from an observational cohort of mechanically ventilated ICU survivors from Denmark found a higher incidence of mood and anxiety disorders (e.g., depression, post-traumatic stress disorder [PTSD]), as compared to non-ICU hospitalized patients [4]. Furthermore, ICU survivors had an increased use of psychotropic medications, particularly antidepressants and sedative-hypnotics. Two large cohorts from separate populations in Canada similarly found that ICU survivorship was associated with increased incidence of new mental health diagnoses [5, 6], a relationship that persisted for years following ICU discharge. There is also evidence that survivors of critical illness are at risk of substance misuse [6]. Among opioid naïve patients experiencing mechanical ventilation, 2.6% were found to have persistent opioid use after discharge, which was higher than matched non-ICU control patients (1.5%) [7]. Finally, more recent work from Ontario, Canada found that ICU survivors have higher rates of deliberate self-harm and suicide, as compared to matched non-ICU hospitalized patients [8]. Thus, in addition to the common physical and cognitive sequelae that they experience, survivors of critical illness are at increased risk of new mental health diagnoses, psychotropic medication use, substance misuse, deliberate self-harm, and suicide. This work has identified an important aspect of PICS that providers must consider in the care of the critically ill...

Language: en