OCTOBER CPE Article ICU Recovery Challenges Authors: Ariana N.Chambers, PY4 Pharm.D candidate 2021 and Jimmi Hatton Kolpek, Pharm.D. The authors declare that there are no financial relationships that could be perceived as real or apparent conflicts of interest. Universal Activity # 0143-0000-20-010-H05-P &T 1.0 Contact Hours (0.1 CEU) Expires 10/30/23 Learning Objectives: At the conclusion of this Knowledge-based article, the reader should be able to: Pharmacist Objectives: 1.
Define Post-ICU Syndrome
2.
Identify the components of the ABCDEF bundle
3.
Recognize the role of a pharmacist during and post-ICU stay in both in-patient and community or ambulatory settings
4. Obtain/access resources that can be given to patients possibly suffering from PICS Pharmacy Technician Objectives: 1.
Define Post-ICU Syndrome
2.
Identify the components of the ABCDEF bundle
3.
Recognize possible signs of PICS in your patient population that can be referred to the pharmacist for additional resources
We all know someone who has been in a severe car accident, suffered from a stroke or heart attack, had post-operative complications, pneumonia, coronavirus, and the list of emergency situations that could lead to an intensive care unit visit continues. According to the Society of Critical Care Medicine (SCCM), there are approximately 5 million individuals admitted to the ICU yearly in the United States. Unfortunately, around one-third of these patients will be placed on mechanical ventilation [1]. However, did you know that anywhere from 30 to 70% of these 5 million individuals will go on to develop a new syndrome because of their ICU stay? [2] What is Post-Intensive Care Unit Syndrome? Post-Intensive Care Unit Syndrome (PICS) was first defined by the Society of Critical Care Medicine in 2010. It presents as a change or worsening of cognition, physical or psychological function after criti-
cal illness. Symptoms include ICU-acquired weakness, cognitive or brain dysfunction such as memory problems, inability to organize thoughts or complete tasks, sleep disturbances, anxiety and posttraumatic stress disorder (PTSD) [3]. PICS can occur within 2 days to weeks or months following an ICU stay. No definitive timeline for onset or duration has been reported, although most ICU recovery clinics evaluate patients within three months of ICU discharge and follow them up to one year. When patients are in the ICU, it is important to manage risk factors associated with developing PICS. They can be separated into ICU-related risk factors such as delirium, immobility, failed communication, systemic corticosteroids, sepsis, acute respiratory distress syndrome, renal replacement therapy, sedative use, and prolonged mechanical ventilation greater than seven days [2,4]. As stated |21| www.KPHANET.org
