title: Recovery and outcomes after the acute respiratory distress syndrome (ARDS) in patients and their family caregivers.
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.
authors.affiliation: Critical Care and Respiratory Medicine, Toronto General Research Institute, University of Toronto, Toronto, ON, Canada. margaret.herridge@uhn.on.ca.
authors.forename: Margaret S
authors.initials: MS
authors.lastname: Herridge
authors.affiliation: Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
authors.forename: Marc
authors.initials: M
authors.lastname: Moss
authors.affiliation: Harborview Medical Center, University of Washington, Seattle, WA, USA.
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Hough
authors.affiliation: Psychology Department, Brigham Young University, Provo, UT, USA.|Neuroscience Center, Brigham Young University, Provo, UT, USA.|Department of Medicine, Pulmonary and Critical Care Medicine, Intermountain Medical Center, Murray, UT, USA.|Center for Humanizing Critical Care, Intermountain Health Care, Murray, UT, USA.
authors.forename: Ramona O
authors.initials: RO
authors.lastname: Hopkins
authors.affiliation: Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Department of Medicine, Nashville, TN, USA.
authors.forename: Todd W
authors.initials: TW
authors.lastname: Rice
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: O Joseph
authors.initials: OJ
authors.lastname: Bienvenu
authors.affiliation: Medical ICU of the Saint-Louis Hospital, Paris Diderot Sorbonne University, Paris, France.
authors.forename: Elie
authors.initials: E
authors.lastname: Azoulay
mesh_terms: D017028:Caregivers / Q000523:psychology*; D003072:Cognition Disorders / Q000209:etiology; D004185:Disability Evaluation; D006801:Humans; D007362:Intensive Care Units; D019964:Mood Disorders / Q000209:etiology; D018908:Muscle Weakness / Q000209:etiology; D011115:Polyneuropathies / Q000209:etiology; D011788:Quality of Life; D012128:Respiratory Distress Syndrome / Q000150:complications* / Q000503:physiopathology* / Q000523:psychology*; D012129:Respiratory Function Tests; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology; D017741:Survivors / Q000523:psychology*
keywords: Acute respiratory distress syndrome (ARDS); Cost; Healthcare utilization; ICU acquired weakness; Neuropsychological; Outcome