Critical care clinics
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Critical care clinics · Jul 2017
ReviewPosttraumatic Stress Disorder Phenomena After Critical Illness.
This article focuses on a psychiatric morbidity in critical illness survivors, posttraumatic stress disorder (PTSD). We present a case in the second person, because it is helpful to imagine what being critically ill can be like from the perspective of a patient without medical training. One-fifth of critical illness survivors have clinically relevant PTSD symptoms in the year after intensive care, and markers of risk include prior psychiatric illness, benzodiazepine administration in the intensive care unit (ICU), and early post-ICU memories of frightening, nightmare-like experiences during intensive care. ICU diaries are a low-tech, low-cost interventions that can supplement psychiatric care.
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Respiratory conditions are some of the most common indications for admission to critical care units. Psychiatric disorders and symptoms are highly comorbid with lung disease. ⋯ Patients can experience a myriad of mood, anxiety, and cognitive disorder symptoms and conditions in critical care units. Intensivists and psychiatrists must be aware of the interplay between pulmonary and psychiatric symptoms as well as medication effects and interactions.
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Critical care clinics · Jul 2017
ReviewAcute Brain Failure: Pathophysiology, Diagnosis, Management, and Sequelae of Delirium.
Delirium is the most common psychiatric syndrome found in the general hospital setting, with an incidence as high as 87% in the acute care setting. Delirium is a neurobehavioral syndrome caused by the transient disruption of normal neuronal activity secondary to systemic disturbances. The development of delirium is associated with increased morbidity, mortality, cost of care, hospital-acquired complications, placement in specialized intermediate and long-term care facilities, slower rate of recovery, poor functional and cognitive recovery, decreased quality of life, and prolonged hospital stays. This article discusses the epidemiology, known etiological factors, presentation and characteristics, prevention, management, and impact of delirium.
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Critical care clinics · Jul 2017
ReviewPsychiatric Disorders and Suicidality in the Intensive Care Unit.
Suicidality is a general term that describes the continuum of suicidal ideation, intent, self-injurious behavior, attempts, and completed suicide. Suicidality across the entire spectrum is a public health concern with significant impact, including billions in work loss and medical costs. There are many challenges to managing suicidality in an intensive care unit setting, which will be reviewed here. Additionally, this article will review the prevalence of suicide attempts in different psychiatric diagnoses, conducting a suicide assessment, role of involuntary psychiatric holds, and most common challenges encountered in the ICU setting.