Study protocol: The Intensive Care Outcome Network ('ICON') study

<p>Abstract</p> <p>Background</p> <p>Extended follow-up of survivors of ICU treatment has shown many patients suffer long-term physical and psychological consequences that affect their health-related quality of life. The current lack of rigorous longitudinal studies means that the true prevalence of these physical and psychological problems remains undetermined.</p> <p>Methods/Design</p> <p>The ICON (Intensive Care Outcome Network) study is a multi-centre, longitudinal study of survivors of critical illness. Patients will be recruited prior to hospital discharge from 20–30 ICUs in the UK and will be assessed at 3, 6, and 12 months following ICU discharge for health-related quality of life as measured by the Short Form-36 (SF-36) and the EuroQoL (EQ-5D); anxiety and depression as measured by the Hospital Anxiety and Depression Scale (HADS); and post traumatic stress disorder (PTSD) symptoms as measured by the PTSD Civilian Checklist (PCL-C). Postal questionnaires will be used.</p> <p>Discussion</p> <p>The ICON study will create a valuable UK database detailing the prevalence of physical and psychological morbidity experienced by patients as they recover from critical illness. Knowledge of the prevalence of physical and psychological morbidity in ICU survivors is important because research to generate models of causality, prognosis and treatment effects is dependent on accurate determination of prevalence. The results will also inform economic modelling of the long-term burden of critical illness.</p> <p>Trial Registration</p> <p>ISRCTN69112866</p

Successive phases of the metabolic response to stress

The metabolic response to stress have been selected as an adaptive response to survive critical illness. Several mechanisms well preserved over the evolution, including the stimulation of the sympathetic nervous system, the release of pituitary hormones, a peripheral resistance to the effects of these and other anabolic factors are triggered to increase the provision of energy substrates to the vital tissues. After an acute insult, alternative substrates are used as a result of the loss of control of energy substrate utilization. The clinical consequences of the metabolic response to stress include sequential changes in energy expenditure, stress hyperglycemia, changes in body composition, psychological and behavioral problems. The loss of muscle proteins and function is a major long-term consequence of stress metabolism. Specifi c therapeutic interventions, including hormone supplementation, enhanced protein intake and early mobilization are investigated.SCOPUS: ch.binfo:eu-repo/semantics/publishe