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Article: To B or not to B?: it still is the question.

Suchyta, Mary R

2004 Volume 125, Issue 1, Page(s) 5–7

MeSH term(s)	Biopsy/methods ; Humans ; Lung/pathology ; Respiratory Distress Syndrome, Adult/diagnosis ; Respiratory Distress Syndrome, Adult/pathology
Language	English
Publishing date	2004-01
Publishing country	United States
Document type	Comment ; Editorial
ZDB-ID	1032552-9
ISSN	1931-3543 ; 0012-3692
ISSN (online)	1931-3543
ISSN	0012-3692
DOI	10.1378/chest.125.1.5
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Article ; Online: Critical illness acquired brain injury: Neuroimaging and implications for rehabilitation.

Hopkins, Ramona O / Suchyta, Mary R / Beene, Katrin / Jackson, James C

Rehabilitation psychology

2016 Volume 61, Issue 2, Page(s) 151–164

Abstract: Objective: The increasing likelihood of surviving critical illness has resulted in a large and growing number of individuals transitioning from medical and surgical intensive care units (ICUs) to their homes. Many ICU survivors develop pervasive ... ...

Abstract	Objective: The increasing likelihood of surviving critical illness has resulted in a large and growing number of individuals transitioning from medical and surgical intensive care units (ICUs) to their homes. Many ICU survivors develop pervasive morbidities in physical, psychological, and cognitive functioning that adversely impact day-to-day functioning, ability to return to work, and quality-of-life. These individuals have been extensively studied with neuropsychological test batteries, but relatively little research has been conducted using neuroimaging. This paper reviews neuroimaging findings in survivors of critical illness treated in medical or surgical ICUs. Methods: We assessed the relationships between abnormalities on neuroimaging and cognitive outcomes and discussed the implications for rehabilitation. Results: There are limited imaging studies in ICU survivors. These studies use a wide range of modalities including magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), diffusion tensor imaging (DTI), fluid attenuated inversion recovery (FLAIR), and diffusion weighted imaging. Structural abnormalities in survivors of critical illness include cortical and subcortical lesions, white matter hyperintensities (WMHs), and generalized and focal atrophy. These abnormalities persist months to years after ICU discharge and are associated with cognitive impairments. (PsycINFO Database Record
MeSH term(s)	Brain/pathology ; Brain Injury, Chronic/diagnosis ; Brain Injury, Chronic/psychology ; Brain Injury, Chronic/rehabilitation ; Cognition Disorders/diagnosis ; Cognition Disorders/psychology ; Cognition Disorders/rehabilitation ; Critical Illness/psychology ; Critical Illness/rehabilitation ; Humans ; Intensive Care Units ; Neuroimaging ; Prognosis ; Risk Factors
Language	English
Publishing date	2016-05
Publishing country	United States
Document type	Journal Article ; Review ; Webcasts
ZDB-ID	224747-1
ISSN	1939-1544 ; 0090-5550
ISSN (online)	1939-1544
ISSN	0090-5550
DOI	10.1037/rep0000088
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Article ; Online: Psychological Sequelae in Family Caregivers of Critically III Intensive Care Unit Patients. A Systematic Review.

Johnson, Candice C / Suchyta, Mary R / Darowski, Emily S / Collar, Erin M / Kiehl, Amy L / Van, Julie / Jackson, James C / Hopkins, Ramona O

Annals of the American Thoracic Society

2019 Volume 16, Issue 7, Page(s) 894–909

Abstract: Rationale: ...

Abstract	Rationale:
MeSH term(s)	Age Factors ; Anxiety/diagnosis ; Anxiety/epidemiology ; Caregivers/psychology ; Caregivers/statistics & numerical data ; Critical Care/methods ; Critical Illness/therapy ; Depression/diagnosis ; Depression/epidemiology ; Female ; Follow-Up Studies ; Humans ; Incidence ; Intensive Care Units ; Male ; Quality of Life ; Randomized Controlled Trials as Topic ; Risk Assessment ; Stress Disorders, Post-Traumatic/psychology ; Stress, Psychological/epidemiology ; Stress, Psychological/etiology ; Stress, Psychological/physiopathology
Language	English
Publishing date	2019-04-04
Publishing country	United States
Document type	Journal Article ; Systematic Review
ZDB-ID	2717461-X
ISSN	2325-6621 ; 1943-5665 ; 2325-6621
ISSN (online)	2325-6621 ; 1943-5665
ISSN	2325-6621
DOI	10.1513/AnnalsATS.201808-540SR
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Article ; Online: Instrumental Activities of Daily Living after Critical Illness: A Systematic Review.

Hopkins, Ramona O / Suchyta, Mary R / Kamdar, Biren B / Darowski, Emily / Jackson, James C / Needham, Dale M

Annals of the American Thoracic Society

2017 Volume 14, Issue 8, Page(s) 1332–1343

Abstract: Rationale: Poor functional status is common after critical illness, and can adversely impact the abilities of intensive care unit (ICU) survivors to live independently. Instrumental activities of daily living (IADL), which encompass complex tasks ... ...

Abstract	Rationale: Poor functional status is common after critical illness, and can adversely impact the abilities of intensive care unit (ICU) survivors to live independently. Instrumental activities of daily living (IADL), which encompass complex tasks necessary for independent living, are a particularly important component of post-ICU functional outcome. Objectives: To conduct a systematic review of studies evaluating IADLs in survivors of critical illness. Methods: We searched PubMed, CINAHL, Cochrane Library, SCOPUS, and Web of Science for all relevant English-language studies published through December 31, 2016. Additional articles were identified from personal files and reference lists of eligible studies. Two trained researchers independently reviewed titles and abstracts, and potentially eligible full text studies. Eligible studies included those enrolling adult ICU survivors with IADL assessments, using a validated instrument. We excluded studies involving specific ICU patient populations, specialty ICUs, those enrolling fewer than 10 patients, and those that were not peer-reviewed. Variables related to IADLs were reported using the Patient Reported Outcomes Measurement Information System (PROMIS). Results: Thirty of 991 articles from our literature search met inclusion criteria, and 23 additional articles were identified from review of reference lists and personal files. Sixteen studies (30%) published between 1999 and 2016 met eligibility criteria and were included in the review. Study definitions of impairment in IADLs were highly variable, as were reported rates of pre-ICU IADL dependencies (7-85% of patients). Eleven studies (69%) found that survivors of critical illness had new or worsening IADL dependencies. In three of four longitudinal studies, survivors with IADL dependencies decreased over the follow-up period. Across multiple studies, no risk factors were consistently associated with IADL dependency. Conclusions: Survivors of critical illness commonly experience new or worsening IADL dependency that may improve over time. As part of ongoing efforts to understand and improve functional status in ICU survivors, future research must focus on risk factors for IADL dependencies and interventions to improve these cognitive and physical dependencies after critical illness.
MeSH term(s)	Activities of Daily Living ; Adult ; Cognition ; Critical Illness/therapy ; Humans ; Intensive Care Units ; Randomized Controlled Trials as Topic ; Survivors/psychology
Language	English
Publishing date	2017-08
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Review
ZDB-ID	2717461-X
ISSN	2325-6621 ; 1943-5665 ; 2325-6621
ISSN (online)	2325-6621 ; 1943-5665
ISSN	2325-6621
DOI	10.1513/AnnalsATS.201701-059SR
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Article ; Online: Return to work after critical illness: a systematic review and meta-analysis.

Kamdar, Biren B / Suri, Rajat / Suchyta, Mary R / Digrande, Kyle F / Sherwood, Kyla D / Colantuoni, Elizabeth / Dinglas, Victor D / Needham, Dale M / Hopkins, Ramona O

Thorax

2019 Volume 75, Issue 1, Page(s) 17–27

Abstract: Background: Survivors of critical illness often experience poor outcomes after hospitalisation, including delayed return to work, which carries substantial economic consequences.: Objective: To conduct a systematic review and meta-analysis of return ... ...

Abstract	Background: Survivors of critical illness often experience poor outcomes after hospitalisation, including delayed return to work, which carries substantial economic consequences. Objective: To conduct a systematic review and meta-analysis of return to work after critical illness. Methods: We searched PubMed, Embase, PsycINFO, CINAHL and Cochrane Library from 1970 to February 2018. Data were extracted, in duplicate, and random-effects meta-regression used to obtain pooled estimates. Results: Fifty-two studies evaluated return to work in 10 015 previously employed survivors of critical illness, over a median (IQR) follow-up of 12 (6.25-38.5) months. By 1-3, 12 and 42-60 months' follow-up, pooled return to work prevalence (95% CI) was 36% (23% to 49%), 60% (50% to 69%) and 68% (51% to 85%), respectively ( Conclusion: Approximately two-thirds, two-fifths and one-third of previously employed intensive care unit survivors are jobless up to 3, 12 and 60 months following hospital discharge. Survivors returning to work often experience job loss, occupation change or worse employment status. Interventions should be designed and evaluated to reduce the burden of this common and important problem for survivors of critical illness. Trial registration number: PROSPERO CRD42018093135.
MeSH term(s)	Critical Illness ; Humans ; Intensive Care Units ; Return to Work ; Risk Factors
Language	English
Publishing date	2019-11-08
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Research Support, N.I.H., Extramural ; Systematic Review
ZDB-ID	204353-1
ISSN	1468-3296 ; 0040-6376
ISSN (online)	1468-3296
ISSN	0040-6376
DOI	10.1136/thoraxjnl-2019-213803
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Article ; Online: Neurologic changes during critical illness: brain imaging findings and neurobehavioral outcomes.

Suchyta, Mary R / Jephson, Al / Hopkins, Ramona O

Brain imaging and behavior

2010 Volume 4, Issue 1, Page(s) 22–34

Abstract: Encephalopathy and other neurologic morbidities are common in critical illness, sepsis, and prolonged mechanical ventilation. We assessed structural changes on brain imaging and neuropsychological outcomes in critically ill patients who developed ... ...

Abstract	Encephalopathy and other neurologic morbidities are common in critical illness, sepsis, and prolonged mechanical ventilation. We assessed structural changes on brain imaging and neuropsychological outcomes in critically ill patients who developed neurological changes during their intensive care unit (ICU) stay. Patients who underwent brain imaging for neurological changes were included in the study. Medical, neuroradiological, and outcome data were obtained from patient medical records. Sixty-four patients underwent brain imaging for neurological changes. Forty-one (64%) patients had abnormalities on brain imaging. There were no differences for age, hospital length of stay, ICU length of stay, duration of mechanical ventilation or APACHE II scores for patients with normal compared to abnormal brain imaging. Cognitive impairments occurred in 48% of survivors and 6% developed psychiatric disorders. Our study demonstrates that abnormalities on brain imaging are common in critically ill patients. We also confirm previous findings that survivors of critical illness have cognitive impairments post-ICU discharge. This study further illustrates the adverse effects of critical illness on the brain and highlights the need for additional research in this emerging area.
MeSH term(s)	Adult ; Age Factors ; Aged ; Aged, 80 and over ; Brain/diagnostic imaging ; Brain/pathology ; Cognition Disorders/complications ; Cognition Disorders/diagnostic imaging ; Cognition Disorders/pathology ; Critical Illness/mortality ; Humans ; Intensive Care Units ; Length of Stay ; Magnetic Resonance Imaging ; Mental Disorders/complications ; Mental Disorders/diagnostic imaging ; Mental Disorders/pathology ; Middle Aged ; Respiration, Artificial ; Tomography, X-Ray Computed ; Young Adult
Language	English
Publishing date	2010-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	2377165-3
ISSN	1931-7565 ; 1931-7557
ISSN (online)	1931-7565
ISSN	1931-7557
DOI	10.1007/s11682-009-9082-3
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Article ; Online: Improving post-intensive care unit neuropsychiatric outcomes: understanding cognitive effects of physical activity.

Hopkins, Ramona O / Suchyta, Mary R / Farrer, Thomas J / Needham, Dale

American journal of respiratory and critical care medicine

2012 Volume 186, Issue 12, Page(s) 1220–1228

Abstract: Critical illness and its treatment often result in long-term neuropsychiatric morbidities. Consequently, there is a need to focus on means to prevent or ameliorate these morbidities. Animal models provide important data regarding the neurobiological ... ...

Abstract	Critical illness and its treatment often result in long-term neuropsychiatric morbidities. Consequently, there is a need to focus on means to prevent or ameliorate these morbidities. Animal models provide important data regarding the neurobiological effects of physical activity, including angiogenesis, neurogenesis, and release of neurotrophic factors that enhance plasticity. Studies in noncritically ill patients demonstrate that exercise is associated with increased cerebral blood flow, neurogenesis, and brain volume, which are associated with improved cognition. Clinically, research in both healthy and diseased human subjects suggests that exercise improves neuropsychiatric outcomes. In the critical care setting, early physical rehabilitation and mobilization are safe and feasible, with demonstrated improvements in physical functional outcomes. Such activity may also reduce the duration of delirium in the intensive care unit (ICU) and improve neuropsychiatric outcomes, although data are limited. Barriers exist regarding implementing ICU rehabilitation in routine care, including use of sedatives and lack of awareness of post-ICU cognitive impairments. Further research is necessary to determine whether prior animal and human research, in conjunction with preliminary results from existing ICU studies, can translate into improvements for neuropsychiatric outcomes in critically ill patients. Studies are needed to evaluate biological mechanisms, risk factors, the role of pre-ICU functional level, and the timing, duration, and type of physical activity for optimal patient outcomes.
MeSH term(s)	Aging/physiology ; Aging/psychology ; Animals ; Brain/physiology ; Brain Injuries/complications ; Brain Injuries/etiology ; Brain Injuries/rehabilitation ; Cognition Disorders/etiology ; Cognition Disorders/prevention & control ; Cognition Disorders/rehabilitation ; Continuity of Patient Care/standards ; Critical Illness/psychology ; Critical Illness/rehabilitation ; Delirium/complications ; Delirium/etiology ; Delirium/prevention & control ; Delirium/therapy ; Disease Models, Animal ; Exercise/physiology ; Exercise/psychology ; Humans ; Intensive Care Units/standards ; Neurogenesis/physiology ; Patient Discharge/standards ; Primates ; Quality Improvement/standards ; Rats
Language	English
Publishing date	2012-12-15
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1180953-x
ISSN	1535-4970 ; 0003-0805 ; 1073-449X
ISSN (online)	1535-4970
ISSN	0003-0805 ; 1073-449X
DOI	10.1164/rccm.201206-1022CP
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Article: Neurologic Changes during Critical Illness: Brain Imaging Findings and Neurobehavioral Outcomes

Suchyta, Mary R / Jephson, Al / Hopkins, Ramona O

Brain imaging and behavior. 2010 Mar., v. 4, no. 1

2010

Abstract	Encephalopathy and other neurologic morbidities are common in critical illness, sepsis, and prolonged mechanical ventilation. We assessed structural changes on brain imaging and neuropsychological outcomes in critically ill patients who developed neurological changes during their intensive care unit (ICU) stay. Patients who underwent brain imaging for neurological changes were included in the study. Medical, neuroradiological, and outcome data were obtained from patient medical records. Sixty-four patients underwent brain imaging for neurological changes. Forty-one (64%) patients had abnormalities on brain imaging. There were no differences for age, hospital length of stay, ICU length of stay, duration of mechanical ventilation or APACHE II scores for patients with normal compared to abnormal brain imaging. Cognitive impairments occurred in 48% of survivors and 6% developed psychiatric disorders. Our study demonstrates that abnormalities on brain imaging are common in critically ill patients. We also confirm previous findings that survivors of critical illness have cognitive impairments post-ICU discharge. This study further illustrates the adverse effects of critical illness on the brain and highlights the need for additional research in this emerging area.
Language	English
Dates of publication	2010-03
Size	p. 22-34.
Publisher	Springer-Verlag
Publishing place	New York
Document type	Article
ZDB-ID	2377165-3
ISSN	1931-7565 ; 1931-7557
ISSN (online)	1931-7565
ISSN	1931-7557
DOI	10.1007/s11682-009-9082-3
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Article ; Online: Risk factors for depression and anxiety in survivors of acute respiratory distress syndrome.

Hopkins, Ramona O / Key, Colin W / Suchyta, Mary R / Weaver, Lindell K / Orme, James F

General hospital psychiatry

2010 Volume 32, Issue 2, Page(s) 147–155

Abstract: Objective: Depression and anxiety are common morbidities of critical illness. We assessed risk factors of depression and anxiety in Acute Respiratory Distress Syndrome (ARDS) survivors at 1 and 2 years post-hospital discharge.: Method: Risk factors ... ...

Abstract	Objective: Depression and anxiety are common morbidities of critical illness. We assessed risk factors of depression and anxiety in Acute Respiratory Distress Syndrome (ARDS) survivors at 1 and 2 years post-hospital discharge. Method: Risk factors for depression and anxiety at 1 and 2 years were assessed using stepwise multiple regression analyses, with and without 1-year outcomes. Results: ARDS survivors had depression (16% and 23%) and anxiety (24% and 23%) at 1 and 2 years, respectively. Predictors of depression at 1 year were alcohol dependence, female gender and younger age (P=.006). Predictors of anxiety were ratio of arterial oxygen tension to inspired oxygen fraction and duration of mechanical ventilation (P<.005). Predictors of depression at 2 years were depression at 1 year and the presence of cognitive sequelae (P<.0001). Predictors of anxiety at 2 years was anxiety at 1 year (P<.0001). Conclusions: Medical variables that predicted depression or anxiety at 1 year no longer predicted depression and anxiety at 2 years. Medical variables appear to have a short-term effect on psychiatric outcomes. At 2 years lifestyle behaviors including history of smoking along with cognitive sequelae, depression and anxiety at 1 year predict depression and anxiety.
MeSH term(s)	Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Anxiety Disorders/diagnosis ; Anxiety Disorders/epidemiology ; Anxiety Disorders/etiology ; Cognition Disorders/diagnosis ; Cognition Disorders/epidemiology ; Depressive Disorder, Major/diagnosis ; Depressive Disorder, Major/epidemiology ; Depressive Disorder, Major/etiology ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Humans ; Male ; Middle Aged ; Neuropsychological Tests ; Patient Discharge/statistics & numerical data ; Prospective Studies ; Respiration, Artificial/methods ; Respiration, Artificial/statistics & numerical data ; Respiratory Distress Syndrome, Adult/mortality ; Respiratory Distress Syndrome, Adult/psychology ; Respiratory Distress Syndrome, Adult/rehabilitation ; Risk Factors ; Severity of Illness Index ; Sex Distribution ; Substance-Related Disorders/diagnosis ; Substance-Related Disorders/epidemiology ; Substance-Related Disorders/psychology ; Survival Rate ; Time Factors ; Young Adult
Language	English
Publishing date	2010-03
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	392299-6
ISSN	1873-7714 ; 0163-8343
ISSN (online)	1873-7714
ISSN	0163-8343
DOI	10.1016/j.genhosppsych.2009.11.003
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Article: The changing face of organ failure in ARDS.

Suchyta, Mary R / Orme, James F / Morris, Alan H

Chest

2003 Volume 124, Issue 5, Page(s) 1871–1879

Abstract: Objective: To study morbidity and mortality in ARDS patients from 1987 to 1999.: Design: Review of a prospectively collected database of ARDS patients.: Setting: Large, community hospital located in Salt Lake City, UT.: Patients: ARDS patients ... ...

Abstract	Objective: To study morbidity and mortality in ARDS patients from 1987 to 1999. Design: Review of a prospectively collected database of ARDS patients. Setting: Large, community hospital located in Salt Lake City, UT. Patients: ARDS patients identified for the years 1987 to 1999. We prospectively identified ARDS patients at LDS Hospital in Salt Lake City, UT, using PaO(2)/fraction of inspired oxygen ratio (P/F) criteria, the presence of bilateral chest radiograph infiltrates, and the absence of left atrial hypertension. Measurements: We assigned a primary risk factor for ARDS and identified the presence of organ failure before and after ARDS. We compared two temporal groups (ie, 1987 to 1990 vs 1994 to 1999) and used two criteria of arterial hypoxemia (P/F: patients from 1994 to 1999, < or = 105 and < or = 173; patients from 1987 to 1990, < or = 0.2) At 1,500 m (the altitude of Salt Lake City), a PaO(2) of < or = 173 corresponds to an alveolar-arterial oxygen pressure difference of < or = 200 at sea level. We used death at hospital discharge as an end point. Main results: We identified 516 ARDS patients with a P/F of < or = 105 (1987 to 1990, 256 patients; 1994 to 1999, 260 patients). Patients who had ARDS between 1994 and 1999 with a P/F of < or = 105 had a lower mortality rate than patients between 1987 and 1990 with a P/F of < or = 105 (44% vs 54%, respectively; p <.05). There were 288 patients with a P/F range of 106 to 173 during 1994 to 1999. Patients from 1994 to 1999 with a P/F of < or = 173 had a lower mortality rate compared to patients from 1987 to 1990 (35% vs 54%, respectively; p <.01). Patients from 1994 to 1999 (for both P/F groups) had statistically fewer total nonpulmonary organ failures (ie, more patients had zero organ failures or single organ failures) and fewer specific organ failures (ie, sepsis, cardiovascular failures, and CNS failures). There were statistically fewer cases of cardiovascular failure, sepsis, and in both periods (ie, prior to ARDS and after the onset of ARDS) for 1994-to-1999 patients with a P/F of < or = 105 compared to 1987-to-1990 patients with a P/F of < or = 105. Conclusions: Mortality from ARDS has decreased and is associated with decreased organ failure prior to and during the course of ARDS.
MeSH term(s)	Female ; Humans ; Male ; Middle Aged ; Multiple Organ Failure/epidemiology ; Multiple Organ Failure/etiology ; Respiratory Distress Syndrome, Adult/complications ; Respiratory Distress Syndrome, Adult/mortality ; Respiratory Distress Syndrome, Adult/physiopathology ; Survival Rate
Language	English
Publishing date	2003-11
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	1032552-9
ISSN	1931-3543 ; 0012-3692
ISSN (online)	1931-3543
ISSN	0012-3692
DOI	10.1378/chest.124.5.1871
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