Psyche revived by Cupid's kiss
to Enhance Recovery On Intensive Care
- “Open ICU” and cooperation with
relatives (communication, physiotherapy, nutrition, diaries, …).
analgesia ever (measured with VNR or BPS) together with light (conscious)
sedation, measured with RASS or SAS,
within 48h from ICU admission and use of protocols, like
“analgesia-first sedation”, use of dexmedetomidine, enteral approach with
interruption of continuous sedatives each morning and coordination with
- Delirium screening (with
CAM-ICU or ICDSC), prevention and early intervention with
non-pharmacologic protocol, by stopping deliriogenic drugs, considering
- Communication strategies:
- towards patients
(visual/hearing aids, calling by name, augmentative/alternative
- towards relatives (brochures,
website, meeting rules, direct explanations, psychologist’s
- Reorientation strategies:
- in-ICU (personal belongings,
books/newspapers, pc/tablets, practical activities);
- post-ICU (ICU diaries made by
health care team and relatives, follow-up after hospital discharge).
- Patient mobilization and early physiotherapy,
avoid neuromuscular blocking agents.
- Physiological sleep promotion:
- days awake (music and TV, DVD
player, discourage sleep during daytime);
- silent nights (lights off,
noise control, avoid unnecessary procedures);
- melatonin supplementation.
- ICU environment (indirect
lights, beds towards sunlight, alarms without noise, preferred music
- End-of-life decisions and cares
(brochure, meeting with relatives, psychologist’s availability).
- Early joining of energy target,
early normoglycemia, early enteral nutrition,
early nutrition by mouth.
Are you an
heroic intensivist ?
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