How I care for ARDS survivors - Professor Margaret Herridge Artwork

Asia Ventilation Forum

The Asia Ventilation Forum (AVF) is a not-for-profit organisation comprising members from different Asian countries. We share our knowledge and experience in respiratory care and critical care with intensive care unit (ICU) workers across the continent with the aim of improving care and outcomes for the critically ill. There are two AVF Podcast series. "Behind-The-Scenes ICU Stories" invites colleagues to share anything and everything on their personal experiences. Expect heart-to-heart discussions on topics that may or may not have been widely described in the medical literature. "The Challenges of Airway Management During the Pandemic" invites colleagues to share anything and everything on how they deal with various clinical situations. Expect discussions on how experts personalise evidence-based medicine for the patient at the bedside. These Podcasts are hosted by Dr Jason Phua, respiratory physician and intensivist at Alexandra Hospital, National University Health System, Singapore, and Dr Jose Emmanuel Palo, intensivist at The Medical City, the Philippines.

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Asia Ventilation Forum

How I care for ARDS survivors - Professor Margaret Herridge

August 04, 2022 • Season 1 • Episode 19

In this AVF Podcast: ICU Tips & Tricks episode, Professor Margaret Herridge discusses what patients and their loved ones go through after surviving ARDS and how we can help them. Dr. Herridge is a Professor in the Department of Medicine, a Senior Scientist in the Toronto General Hospital Research Institute, Director of the RECOVER Program/Grace RECOVER Program for Chronic Critical Illness, and co-lead (with Dr. Angela Cheung) of CANCOV (Canadian multi-centre 2-year follow-up of patients/caregivers after COVID-19). She has been the lead or co-lead on 5 publications in the New England Journal of Medicine and has published over 200 articles and book chapters on patient and caregiver outcomes after critical illness.

Issues discussed in this interview:

· Long-term physical, cognitive, and psychological complications of ARDS and critical
illness
· Evidence-based interventions to minimise such complications
· Care for ARDS survivors and their loved ones

Work cited:

1. Levine S, Nguyen T, Taylor N, et al. Rapid disuse atrophy of diaphragm fibers in mechanically ventilated humans. N Engl J Med 2008;358:1327-35.

2. Puthucheary ZA, Rawal J, McPhail M, et al. Acute skeletal muscle wasting in critical illness. JAMA 2013;310:1591-600.

3. Herridge MS, Cheung AM, Tansey CM, et al. One-year outcomes in survivors of the acute respiratory distress syndrome. N Engl J Med 2003;348:683-93.

4. Herridge MS, Tansey CM, Matte A, et al. Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med 2011;364:1293-304.

5. Pandharipande PP, Girard TD, Jackson JC, et al. Long-term cognitive impairment after critical illness. N Engl J Med 2013;369:1306-16.

6. Needham DM, Davidson J, Cohen H, et al. Improving long-term outcomes after discharge from intensive care unit: report from a stakeholders' conference. Crit Care Med 2012;40:502-9.

7. Brummel NE, Girard TD, Pandharipande PP, et al. Prevalence and course of frailty in survivors of critical illness. Crit Care Med 2020;48:1419-26.

8. Azoulay E, Resche-Rigon M, Megarbane B, et al. Association of COVID-19 acute respiratory distress syndrome with symptoms of posttraumatic stress disorder in family members after ICU discharge. JAMA 2022;327:1042-50.

9. Huang C, Huang L, Wang Y, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet 2021;397:220-32.

10. Hermans G, Wilmer A, Meersseman W, et al. Impact of intensive insulin therapy on neuromuscular complications and ventilator dependency in the medical intensive care unit. Am J Respir Crit Care Med 2007;175:480-9.

11. Schaller SJ, Anstey M, Blobner M, et al. Early, goal-directed mobilisation in the surgical intensive care unit: a randomised controlled trial. Lancet 2016;388:1377-88.

12. Hughes CG, Mailloux PT, Devlin JW, et al. Dexmedetomidine or propofol for sedation in mechanically ventilated adults with sepsis. N Engl J Med 2021;384:1424-36.

13. Goligher EC, Jonkman AH, Dianti J, et al. Clinical strategies for implementing lung and diaphragm-protective ventilation: avoiding insufficient and excessive effort. Intensive Care Med 2020;46:2314-26.