2023-10-27 18:05:00
According to data from the Siaarti Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care, 54% of its members recognize Resuscitation and Intensive Care as their main area of work. “The Icare 2023 National Congress, which ends tomorrow 28 October, is a moment of scientific dissemination and professional growth, also important for issues relating to the critical area – explains the Head of the Siaarti Scientific Committee, Andrea Cortegiani – The most innovative, important and often controversial aspects – on a scientific or ethical level – on issues related to everyday clinical activity, as well as the most important recent scientific publications, with space for dialogue on clinical application and ideas for future research”.
Among the topics addressed in this area, certainly the importance of “personalizing” care in patients suffering from sepsis and septic shock, respiratory insufficiency with the need for respiratory support, as well as the methods with which it is possible to “phenotype” the diagnosis and therapy on critically ill patients for personalized care. “To guarantee the best care for our patients, we will face the fundamental discussion on the quality of our work as anaesthetists-resuscitators – continues Cortegiani – in this context, the concepts of “fatigue”, i.e. tiredness, demotivation and the burnout that – in a growing percentage of colleagues – accompany our work, and of ‘well-being’, i.e. the need to also pursue the well-being of healthcare personnel, due to their impact on the quality of care provided to patients, especially in the critical area”.
What the discipline is increasingly focusing on is in fact an even more holistic approach to the critically ill patient, which was addressed for example in the session dedicated to the so-called ABCDE bundle. “The meaning of the ABCDEF bundle is to define a series of coordinated actions in the care of a patient in critical conditions that considers all aspects of care, not only medical but also nursing, not only health interventions but also the humanization of care, not only of the function of organs important for survival but of the entire person” clearly explains Nicola Latronico, Head of the Siaarti Cultural Area Resuscitation and Intensive Care.
But in what way? What is it about? “The bundle – underlines Latronico – is a series of processes that includes the evaluation, prevention and treatment of pain, sedation and ventilation, the most appropriate choice of analgesic and sedative drugs, delirium, early mobilization and, last but not least, of the role of the family, both as an active part of the treatment project and as an object of care: families are essential to create the relationship of trust with a team that the patient was not able to choose, but they themselves must be supported along the troubled path and uncertain that it will hopefully allow the patient’s recovery.”
Another topic addressed in the Icare Congress is in fact that of “life after intensive care” and the long-term effects after discharge from these departments. “Today, mortality in intensive care is reduced for many once lethal pathologies – continues Latronico – This has led to the fact that many patients survive an acute event such as trauma, sepsis and respiratory distress with outcomes that can persist long after discharge from hospital, or even forever”.
What is the impact of an ICU admission on patients after discharge? “Post-intensive care syndrome describes a series of physical, cognitive and mental alterations that develop in survivors of intensive care and which have a negative impact on the quality of life – remarks Latronico – muscle weakness, a sense of prostration and fatigue, memory and language disorders, post-traumatic stress, alterations in sleep and the sexual sphere, to name a few, not only profoundly alter people’s daily lives and the resumption of work, but are only rarely recognised. as a unitary pathological entity; more often patients are forced to address fragments of their pathological experiences with different medical specialists.”
Recognizing post-intensive care syndrome is today an absolute priority for patients, but also for the national healthcare system and for the research field. Knowing the existence of the problem is the first step in being able to cure it, also identifying the areas and strategies to improve the clinical-organizational paths in the different regional areas. “Among the topics that will be discussed both from the point of view of scientific evidence and organizational applicability in the various regional macro-areas are in fact the follow-up clinics for patients discharged from intensive care – concludes Vito Torrano, Head of the North Macro-area of Siaarti – which represent an important element for the recovery of patients discharged from intensive care and for their recovery in the autonomy of daily life activities and can have a very important impact on social and healthcare systems”. The introduction of follow-up clinics for patients discharged from intensive care is an element that can offer food for thought and dialogue with patients and institutions: this is the challenge that Siaarti continues to launch year after year.
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