This afternoon’s #ATS2022 session starts with “Diagnosis and Management of Patients and Families with Post Intensive Care Unit Syndrome” with Dr. Hugo Carmona (@HcarmonaMD)! Image
Defining PICS - these 3 domains are the most common impairments for people with PICS. #ATS2022 Image
What tools can we use to identify impairments in these domains? #ATS2022 Image
Early mobilization improves patients walking without assistance at discharge. #ATS2022 Image
Risk factors and PICS - There are pre-illness, hospitalization factors, and post-hospital factors.
#ATS2022 ImageImageImage
The ABCDEF bundle can help improve outcomes. #ATS2022 Image
The bundle improves discharge to home (vs facility) as more of the bundle is performed. #ATS2022 Image
One year outcomes after ARDS - physical impairment and ability to return to work improve with time (but impairments remain). #ATS2022 Image
Physical impairment typically recovers more quickly than the other PICS domains. #ATS2022 Image
Delirium in the ICU is associated with cognitive impairment later. #ATS2022 ImageImage
Steroids and insulin are likely associated with worse physical impairment. #ATS2022 ImageImage
Summary Points #ATS2022 Image
The next talk with Dr. Ann Parker (@AnnEkedahl) is “Post-ICU Clinics: Who Are They For? How Do They Help?” #ATS2022 Image
Definition of PICS #ATS2022 Image
What do patients identify as key components of ICU recovery programs? #ATS2022 Image
This scoping review of post-ICU interventions looked at what interventions were helpful. #ATS2022 ImageImage
These are the interventions that were found to be effective. #ATS2022 Image
This study evaluated the effectiveness of a sepsis transition and recovery program. There were improvements in mortality and readmission. #ATS2022 ImageImage
This study looked at enablers and barriers to implementing ICU follow-up clinics. #ATS2022 Image
These are guidelines for patients who may need rehabilitation after critical illness.
#ATS2022 Image
Consider establishing these things at each step along the way. #ATS2022 Image
This information should be provided to patients and caregivers at discharge. #ATS2022 Image
Key domains to review 2-3 months after discharge. #ATS2022 Image
There are also SCCM guidelines for post-ICU rehabilitation. #ATS2022 Image
Core outcomes that should be evaluated in clinical research in acute respiratory failure survivors.
#ATS2022 Image
Current gaps in knowledge in post-ICU care #ATS2022 Image
Summary points! #ATS2022 Image

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More from @gretchemaben

Oct 2
Today I took a Freedom Trail tour in Boston and learned a lot. Read on to brush up on some history!
William Blackstone signed up for an expedition to come from England to North America in the mid-1620s. He sets up a farm in what is now Boston.
The king of England and the church were not getting along in 1630, so people came over because they wanted a more strict church (puritans) and landed in Charleston, which is marshland.
Read 64 tweets
Sep 9
Here’s something I don’t understand. If I had $10 million invested with a 4% return, I would have $400,000 in interest every year. Even with my mortgage and taxes and a new car every year, I could still buy all the books, take incredible care of my pets, and travel the world. 1/
This amount would also be more than enough to completely retire and open my animal sanctuary which would be self-sustaining (I have it all planned out). And of course this would be without even touching the principal balance. 2/
Don’t get me wrong, I have absolutely no intent of ever having this kind of money. But here’s what I don’t understand - why in the world are we giving all these tax breaks to people with millions and millions of dollars. There are 759 BILLIONAIRES in the U.S. alone! 3/
Read 9 tweets
Mar 21
Travel Tips Thread!

Many of you have reached out, asking me what company I used to plan my trips. I actually plan the vast majority entirely myself. So since so many of you seem curious, here’s how I do it: 1/
Disclaimer 1: For certain polar locations I have booked cruises through Quark Expeditions. These include my trip to Antarctica, as well as upcoming trips to Greenland and Svalbard. I particularly like this company due to their focus on environmental protection and education. 2/
Disclaimer 2: I did use a travel agency for my most recent trip to Africa, because it is very difficult to book, safari and transfers there without someone with expert knowledge of the area. 3/
Read 32 tweets
Jan 22, 2023
My final #SCCM2023 tweetucation session for today is “Late-Breaking Studies Affecting Patient Outcomes”!
First we have “Continued Enteral Nutrition Until Extubation Compared to Fasting Prior to Extubation in the Intensive Care Unit: A Clustered Randomized Trial” with Stephan Ehrmann (@stephanehrmann)! #SCCM2023
Nearly all ICUs impose some form of fasting before extubation, but this time seems to be decreasing. #SCCM2023
Read 121 tweets
Jan 21, 2023
Patient enrollment #SCCM2023
Patient characteristics #SCCM2023
These slides show that they did indeed have a difference in therapies given. #SCCM2023
Read 56 tweets
Jan 21, 2023
My next #SCCM2023 tweetucation session is “Late-Breaking Studies That Will Change Your Practice”!
First we have Dr. Ivor Douglas (@com543) with “Restrictive vs Liberal Fluid Management for Sepsis-Induced Hypotension”! #SCCM2023
So what is the optimal fluid resuscitation strategy in shock? #SCCM2023
Read 10 tweets

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