2023-07-17 07:56:20
For some patients, a passage in intensive care is not without consequences. It may indeed be the cause of a post-resuscitation syndrome that persists for months or even years following discharge from hospital, which has a major impact on their quality of life and their professional activity. Hence the importance of detecting and treating people with post-resuscitation syndrome as early as possible. This is the meaning of the new recommendations of the High Authority for Health. We take stock.
What is post-resuscitation syndrome?
When a patient is in critical condition as a result of illness, serious trauma, major surgery or coma, he is taken care of in a hospital intensive care unit. Under continuous monitoring, he will benefit from care that is supposed to replace the failing vital functions (pulmonary, cardiac, renal, etc.).
However, for some patients, a passage in intensive care is not without consequences. It is estimated that regarding 40% of them suffer from a post-resuscitation syndrome when they leave the hospital. This syndrome is manifested by persistent symptoms of:
- Physical: muscular and neurological disorders, osteoarticular damage, skin sequelae and other specific organ sequelae.
- Psychological or psychiatric: anxiety, depressive or post-traumatic disorders (in 20 to 35% of patients).
- And cognitive: memory loss, loss of verbal fluency, attention problems or alterations in executive functions (in 20 to 50% of patients).
To know ! Post-resuscitation syndrome is also called PICS (for post-intensive care syndrome).
Of varying intensity, these symptoms can manifest themselves for several months or even several years following hospitalization., which can have a serious impact on the quality of life, autonomy and professional activity of patients. It is estimated that 30 to 45% of patients are unable to resume their professional activity twelve months following leaving intensive care!
As for the relatives of patients in intensive care, they are not spared because they too can develop psychological and psychiatric symptoms related to the intense stress experienced during hospitalization. This is called the “PICS Family “. Hence the importance of detecting and taking care of people with post-resuscitation syndrome as early as possible.. This is the meaning of the new recommendations of the High Authority for Health intended for health professionals.
Prevent post-resuscitation syndrome in the patient and his entourage
In its new recommendationsHAS encourages healthcare professionals to identify patients with one or more predisposing factors for PICS when they are admitted to intensive care:
- Patient characteristics (such as age or presence of comorbidities).
- Factors related to their passage in intensive care (reason for admission, length of stay, duration of mechanical ventilation, temporary and sudden state of confusion, etc.).
As for the prevention of PICS Family, the HAS relies on the creation of information protocols intended for relatives. The idea is to encourage communication with family members, to have them actively participate in care if they so wish and not to restrict visiting hours.
Towards a better follow-up of patients following their hospitalization
To ensure continuity of patient care, HAS recommends the systematic transmission of the discharge letter by the intensive care unit to the attending physician and any other health professional. This letter precisely describes the clinical condition of the patient on leaving the hospital, as well as his possible needs in terms of rehabilitation and follow-up. HAS also recommends that resuscitation personnel and/or relatives complete a daily logbook which will also be given to the patient on discharge, under the supervision of a healthcare professional.
To know ! The logbook traces the events that occurred during the hospitalization and aims to reorganize the patient’s memories.
If the post-resuscitation syndrome can appear as soon as you leave the hospital, it can happen weeks or even months later. In this case, health professionals will be able to limit the evolution of symptoms by means of a clinical evaluation repeated over time in patients at risk:
- Before leaving intensive care.
- Then within three to six months of their return home.
In the event that the clinical evaluation reveals serious symptoms, the patients are then taken care of in a specific and coordinated manner. by psychologists, psychiatrists, physiotherapists, organ specialists, speech therapists or general practitioners. The objective of this individual care? Give patients back their full autonomy and help them reintegrate into their social and professional environment.
To know ! The screening and follow-up of patients at risk of PICS are carried out by a multi-professional team, including general practitioners and other health professionals aware of the post-resuscitation syndrome.
Déborah L., Dr in Pharmacy
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