@GallodeMoraesMD will be live tweeting the #PICS talk @accp #CHESTCritCare
@crit_caring_MD @GioraNetzer @itsradu @ICU_Recovery are talking about #PICS now!
At 12 months only 44% of ICU survivors are PICS-free, being cognitive a significative part of the post-ICU impairment. With more ICU survivors, we will likely be seeing more PICS. #CHEST2020 #CHESTCritCare
The lack of visitors in the COVID-19 era, will likely contribute to higher number of survivors with PICS #CHEST2020 #CHESTCritCare
@GioraNetzer reminds us that who is family is determined by the patients. Family engagement is part of the ABCDEF bundle of ICU liberation. 57% of ICU survivors require care by a caregiver after ICU discharge. Patients with good social support do better.
Sequela of critical illness are seen well passed ICU discharge, both in patients and their families. One year after ICU discharge, many caregivers have PTSD, depression and anxiety.
Majority of ICU survivors will have a family member who will have a major change in life-style: loss income, change in jobs/schedules to be able to care for the survivor.
#CHEST2020 #CHESTCritCare @accpchest
The caregivers will need support as well: they will need counseling, psychoeducational interventions, support group and respite. The caregiver should be taken into consideration when a PICS clinic is being planned. #PICS #CHEST2020
Keeping family members engaged is helpful to prevent PICS in survivors and helps with PTSD and anxiety in family members. It is our obligation to provide a tablet or video-conferencing capability to family members in order to decrease social injustices during COVID-19 era.
@itsradu reminds us of the most frequent readmission diagnoses after sepsis survival are new/recurrent infections, CHF exacerbation, AKI, COPD exacerbation, aspiration pneumonia
Pre-existing cognitive dysfunction/mental health is a risk factor for the development of #PICS, these patients would benefit from more aggressive implementation of the ABCDEF bundle. #CHEST2020 #CHESTCritCare
Proactive contact by case-managers with telephone calls soon after discharge prevents readmissions, increases survival and is also cost-saving. #CHESTCritCare #CHEST2020

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More from @CHESTCritCare

21 Oct
Get your popcorn ready because this is going to be quite the learning contest. #CHEST2020

The webinar is LIVE in T - 5mins, speakers are checking their 🎤🎤

We are only a tiny bit biased towards our co-chair @GallodeMoraesMD!
Dr. Mathews: Starts with sharing what drives ventilation-induced lung injury. This is "leak" is likely more pronounced in #COVID19

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21 Oct
Join us now to learn about Sepsis Antibiotics and Fluids!

Moderated by our co-chair @virenkaul

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Up first is Dr. Angel Coz

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Why broad spectrum antibiotics?? This means:

- not the same for every patient
- based on patient history and source
- based on institutional resistances

Read 30 tweets
21 Oct
Coagulopathy on COVID-19 is about to start! @accpchest #CHEST2020 #CHESTCritCare
Comparison of VTE in other diseases in the ICU #CHEST2020 #CHESTCritCare Image
And comparison of COVID-19 VTE and historical ICU co-horts. Thrombosis in COVID higher in well matched ARDS patients and also higher than in patients with flu. @accpchest #CHEST2020 #CHESTCritCare Image
Read 11 tweets
19 Oct
Starting soon, Sepsis: Most Recent Advances

#CHESTCritCare is going to be Tweeting hightlights live by @crit_caring_MD

Up first, Dr. Matthew Churpek discussing machine learning and big data.

Trade off between high sensitivity and high specificity depending on if you use SIRS vs. qSOFA.

NEWS and MEWS much more acute tools for predicting mortality.

Read 21 tweets
19 Oct
First up: Props to #CHEST2020 learning partners for that amazing wait music. Ne'er been a fan of wait music. But this is ... well .. peppy. Am in the mood to learn about #AirwayManagement!

Speakers: @Chaeface @J_Mendelson_MD @KDoerschug

Coverage: @virenkaul

.@J_Mendelson_MD: HFNC and proning in severe hypoxic resp failure:

- Can reduce dead space ventilation, assist with WOB, improved resp mechanics
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.@Chaeface: Pre-oxygenation modifications to reduce aerosolization

Use V-E technique vs C-E technique for rescue BMV. Improved efficacy for ventilation and better seal. (Lower picture): bit.ly/2H5aY7a

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18 Oct
Vitamins in Critical Illness starting now!

Discussing: Vitamin C, Vitamin B12, Vitamin D

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Vitamin B12 up first by Dr. Jayshil Patel.
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There are elevated hydrogen sulfide (H2S) in early sepsis.
Read 22 tweets

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