Recovery and outcomes after the acute respiratory distress syndrome (ARDS) in patients and their family caregivers |
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| Authors: | Margaret S. Herridge Marc Moss Catherine L. Hough Ramona O. Hopkins O. Joseph Bienvenu Elie Azoulay |
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| Affiliation: | 1.Critical Care and Respiratory Medicine, Toronto General Research Institute,University of Toronto,Toronto,Canada;2.Division of Pulmonary Sciences and Critical Care Medicine,University of Colorado School of Medicine,Aurora,USA;3.Harborview Medical Center,University of Washington,Seattle,USA;4.Psychology Department,Brigham Young University,Provo,USA;5.Neuroscience Center,Brigham Young University,Provo,USA;6.Department of Medicine, Pulmonary and Critical Care Medicine,Intermountain Medical Center,Murray,USA;7.Center for Humanizing Critical Care,Intermountain Health Care,Murray,USA;8.Division of Allergy, Pulmonary, and Critical Care Medicine,Vanderbilt University Department of Medicine,Nashville,USA;9.Department of Psychiatry and Behavioral Sciences,Johns Hopkins University School of Medicine,Baltimore,USA;10.Medical ICU of the Saint-Louis Hospital,Paris Diderot Sorbonne University,Paris,France |
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| Abstract: | Outcomes after acute respiratory distress syndrome (ARDS) are similar to those of other survivors of critical illness and largely affect the nerve, muscle, and central nervous system but also include a constellation of varied physical devastations ranging from contractures and frozen joints to tooth loss and cosmesis. Compromised quality of life is related to a spectrum of impairment of physical, social, emotional, and neurocognitive function and to a much lesser extent discrete pulmonary disability. Intensive care unit-acquired weakness (ICUAW) is ubiquitous and includes contributions from both critical illness polyneuropathy and myopathy, and recovery from these lesions may be incomplete at 5 years after ICU discharge. Cognitive impairment in ARDS survivors ranges from 70 to 100 % at hospital discharge, 46 to 80 % at 1 year, and 20 % at 5 years, and mood disorders including depression and post-traumatic stress disorder (PTSD) are also sustained and prevalent. Robust multidisciplinary and longitudinal interventions that improve these outcomes are still uncertain and data in our literature are conflicting. Studies are needed in family members of ARDS survivors to better understand long-term outcomes of the post-ICU family syndrome and to evaluate how it affects patient recovery. |
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