Lioudmila V. Karnatovskaia, M.D.

Over a third of those who survive critical illness suffer from symptoms of anxiety, depression, or post-traumatic stress disorder (PTSD) after leaving the intensive care unit (ICU). This is twice as high as the rates of PTSD in combat veterans. The strongest risk factor is memories of frightening experiences and delusions (something that is very common during critical illness, when patients feel that something is real when it is actually not). Patients can hear speech even when sedated, yet there is no systematic communication with the critically ill while they receive life-saving medical treatments. We think that lack of real-time communication with patients contributes to their traumatic memories, because patients may not understand why they experience something painful, and what is happening to them. We therefore propose to modify an already existing intervention called ICU diaries to provide this real time communication. Currently it is one of the most commonly used interventions and consists of the treating team and family members writing down the daily events in a diary that the patient receives sometime after the hospital discharge. Unfortunately, ICU diaries have not shown consistent results, perhaps because when the patient reads about their ICU stay, they have already formed traumatic memories of that experience. Aloud reading of ICU diaries in real-time creates a method for systematically ensuring delivery of patient-orientated communication for ICU patients. This communication may therefore prevent negative psychological sequela in ICU survivors by orienting patients to their surroundings and situation; encouraging accurate memories and recall of the ICU experience. Prior to performing a larger study powered to evaluate the efficacy of this intervention on ICU survivor outcomes, we will perform an initial feasibility study to improve upon the current proposed protocol. We plan to assess feasibility via enrollment of 30 patients into a prospective cohort study where compliance with completing diary tasks can be measured and input from important stakeholders such as patients, patient families, room nurses, and physical/occupational therapists can be obtained and evaluated. This study is to determine the feasibility of providing psychological support to ICU patients through reading aloud standard of care daily diary entries by the care team which will be evaluated through feedback from patients and their family members

The purpose of this study is to assess the use of an audio recording containing positive suggestion as a means to provide needed psychological support to critically ill patients in a feasible and reliable manner.

The purpose of this study is to to evaluate feasibility of high fermented food diet among critical illness survivors and its effect on microbiome diversity. Also, to evaluate the effect of high fermented food diet on immune system performance and recovery, mental health, cognition, and quality of life of critical illness survivors.

The purpose of this trial is to compare the effectiveness of psychological support based on positive suggestions (PSBPS) vs. usual care on mental health morbidity and cognitive function in survivors of critical illness.

The purpose of this study is to evaluate whether post-ICU assessment predicts PICS at 3 months and to validate a screening tool to identify patients at risk for PICS.  

The primary purpose of this study is to evaluate whether early treatment with therapeutic hypothermia (TH), along with neuromuscular blockade (NMB) to prevent shivering, will be beneficial to patients with Acute Respiratory Distress Syndrome (ARDS).

The purpose of this study is to measure the frequency and severity of posttraumatic stress symptoms, depressive symptoms, anxiety symptoms, and cognitive impairment following dismissal from the ICU and three months later. This study also seeks to identify which of the multiple ICUs at Mayo Clinic yields the highest incidence of post-intensive care syndrome so that a future study designed to provide a therapeutic intervention can be implemented in those areas with the greatest potential.

The purpose of this study is to test the feasibility of a psychotherapeutic intervention for critically ill patients in intensive care units. The intervention is named Early Psychological Support for the Critically Ill (EPSCI).

The objective of this project is to refine and test a behavioral intervention to be administered in parallel with medical treatment in the ICU.

The purpose of this study is to evaluate the safety and feasibility of kefir administration in critically ill adults.