Addressing Post-Intensive Care Syndrome in Thoracic Surgery Patients: The Role of Psychiatric Rehabilitation – A Systematic Review
DOI:
https://doi.org/10.69980/ajpr.v24i1-2.440Keywords:
Intensive care syndrome, thoracic surgery, psychiatric rehabilitation, lung surgery, Empyema ThoracisAbstract
Post-Intensive Care Syndrome (PICS) includes a spectrum of physical, cognitive, and psychological impairments affecting survivors of critical illness, with thoracic surgery patients who require ICU-level care being particularly vulnerable. This systematic review evaluates the role of psychiatric rehabilitation in managing PICS among thoracic surgery patients. A comprehensive search of PubMed, Embase, Scopus, and the Cochrane Library was conducted for studies, including observational studies, randomized controlled trials, and reviews focusing on psychiatric interventions in this population. Risk of bias was assessed using the Newcastle-Ottawa Scale and Cochrane tools. Of 453 articles screened, 23 met the inclusion criteria. Evidence supports interventions such as cognitive-behavioral therapy (CBT), pharmacotherapy, peer support, and structured post-ICU clinics, all of which were associated with significant improvements in depression, PTSD, anxiety, and cognitive function. Multidisciplinary approaches were more effective than single-modality treatments. These findings underscore the importance of psychiatric rehabilitation as a critical component of post-ICU care in thoracic surgery patients and highlight the need for future research with thoracic-specific populations and standardized outcome measures.
References
1. Needham DM, Davidson J, Cohen H et al. Improving long-term outcomes after discharge from intensive care. Crit Care Med. 2012;40(2):502–509.
2. Kress JP, Hall JB. ICU-acquired weakness and recovery from critical illness. N Engl J Med. 2014;370(17):1626–1635.
3. Pandharipande PP et al. Long-term cognitive impairment after critical illness. N Engl J Med. 2013;369:1306–1316.
4. Desai SV et al. Long-term complications of critical care. Crit Care Med. 2011;39(2):371–379.
5. Hatch R et al. Anxiety, depression and PTSD after critical illness. Crit Care. 2018;22(1):310.
6. Jones C et al. Intensive care diaries reduce PTSD symptoms. Crit Care. 2010;14(5):R168.
7. Bienvenu OJ et al. Pilot study of a telephone-based cognitive behavioral therapy for survivors of ARDS. Intensive Care Med. 2013;39(1):47–55.
8. Brintzenhofe-Szoc KM et al. Mindfulness-based stress reduction and quality of life in lung cancer patients. Psychooncology. 2009;18(7):699–706.
9. Parker AM, Sricharoenchai T, Needham DM. Early rehabilitation in the ICU. Clin Chest Med. 2015;36(3):409–420.
10. Girard TD et al. Pharmacologic prevention of ICU delirium. Curr Opin Crit Care. 2008;14(4):403–407.
11. Van den Boogaard M et al. Haloperidol prophylaxis in critically ill patients. JAMA. 2013;309(7):675–683.
12. Garrouste-Orgeas M et al. Impact of an ICU diary on PTSD symptoms. Crit Care.2012;16(5):R199.
13. Cuthbertson BH et al. The Intensive Care Outcome Network (ICON) study. Crit Care. 2005;9(1):R96–109.
14. Sevin CM et al. Implementation of a post-ICU recovery center. Crit Care Clin. 2018;34(4):655–662.
15. McPeake J et al. The InS:PIRE program: a recovery service for survivors of critical illness. Lancet Respir Med. 2017;5(2):136–137.
16. Kamdar BB et al. Return to work and quality of life after critical illness. Ann Am Thorac Soc. 2020;17(9):1120–1128.
17. Shankar-Hari M et al. Psychiatric morbidity in survivors of critical illness. Intensive Care Med. 2016;42(3):369–378.
18. Carfì A, Bernabei R, Landi F. Persistent symptoms in COVID-19 survivors. JAMA. 2020;324(6):603–605.
19. Vrettou CS et al. Post-intensive care syndrome: Physio-psychiatric implications and therapeutic challenges. Ann Intensive Care. 2022;12(1):43.
Downloads
Published
Issue
Section
License
Copyright (c) 2021 American Journal of Psychiatric Rehabilitation
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License permitting all use, distribution, and reproduction in any medium, provided the work is properly cited.
