Recovery and outcomes after the acute respiratory distress syndrome (ARDS) in patients and their family caregivers

• Published in: Intensive Care Medicine 2016-05, Vol.42 (5), p.725-738
• Main Authors: Herridge, Margaret S., Moss, Marc, Hough, Catherine L., Hopkins, Ramona O., Rice, Todd W., Bienvenu, O. Joseph, Azoulay, Elie
• Format: Article
• Language: English
• Subjects: Acute respiratory distress syndrome; Anesthesiology; Caregivers; Caregivers - psychology; Cognition Disorders - etiology; Critical Care Medicine; Disability Evaluation; Emergency Medicine; Humans; Intensive; Intensive Care Units; Medicine; Medicine & Public Health; Mood Disorders - etiology; Muscle Weakness - etiology; Pain Medicine; Patient outcomes; Pediatrics; Pneumology/Respiratory System; Polyneuropathies - etiology; Post-traumatic stress disorder; Quality of Life; Respiratory distress syndrome; Respiratory Distress Syndrome, Adult - complications; Respiratory Distress Syndrome, Adult - physiopathology; Respiratory Distress Syndrome, Adult - psychology; Respiratory Function Tests; Review; Risk Factors; Stress Disorders, Post-Traumatic - etiology; Survivors - psychology
• ISSN: 0342-4642; 1432-1238
• DOI: 10.1007/s00134-016-4321-8

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.