Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)
Health Services Research
David Livingston, MD, FACS
Wesley J. Howe Professor of Surgery, Chief of Trauma and Surgical Critical Care, Director-Eric Munoz Trauma Center
Rutgers New Jersey Medical School
Rutgers-New Jersey Medical School
Newark, New Jersey
Post-Intensive Care Syndrome (PICS) is the term used to describe the onset of new or worsening impairments in physical, cognitive, or mental health associated with critical illness. As survivorship from intensive care has improved, the incidence of PICS has increased. ICU-acquired weakness affects 25-60% of patients, delirium is observed in 50-80%, pain in 50% and psychiatric symptoms (ie, depression, anxiety, PTSD) in 20-30%. Long-term follow-up studies have shown that symptoms associated with PICS can persist years after the onset of illness. Growing recognition of the consequences of PICS has given rise to a paradigm shift. Until recently, rehabilitation interventions were routinely deferred until medical and surgical stability were achieved. Bolstered by feasibility studies and recent randomized controlled trials, there is evidence that rehabilitation interventions can be safely and effectively initiated within 48 hours of hospital admission.
In this symposium, trauma and rehabilitation specialists will discuss their contributions to acute management of the patient with severe trauma. Representatives from the ACRM and the American College of Surgeons Committee on Trauma (ACS-COT) will review service delivery models and interventions that have been shown to be effective and identify areas in need of improvement. These presentations will be followed by a panel discussion during which ACRM and ACS-COT liaisons cross-appointed to each organization will briefly discuss the opportunities and challenges associated with 4 new initiatives launched through a collaborative agreement between the ACRM, the ACS-COT and the National Institute on Disability, Independent Living and Rehabilitation Research to improve outcome following severe traumatic injury.