Faculty and fellows in the Division are engaged in providing care to critically ill patients in the University of Colorado Hospital’s Medical ICU (UCH-MICU). UCH is the Rocky Mountain Region’s only academic medical center and one of America’s Best Hospitals. UCH is a Level I trauma center, certified by both the Colorado Department of Public Health and Environment, and the American College of Surgeons, and is also a Cardiac Center with 24/7 cardiac catheterization capabilities. UCH is a quaternary care facility serving the Denver metro area and the entire front range. The UCH-MICU is a 24-bed closed unit staffed by Division faculty, with support of PCCM fellows, advanced practice providers, and housestaff from a variety of training programs that include internal medicine, emergency medicine, and family medicine. Excellent multidisciplinary support for patient care is available from nursing, respiratory therapy, pharmacy, nutrition, physical therapy, social work, and case management. Daily rounds include these disciplines. Additionally, given the quaternary care nature of UCH, involvement of consulting services with expertise in transplantation (solid organ and bone marrow), gastroenterology/hepatology, infectious diseases, renal, and others is sought to support patient management. In 2020, the Division also assumed responsibilities in the care of patients with COVID-19 associated respiratory failure in a separate 20-bed Critical Care Annex, where they are supported by fellows and housestaff. A strong emphasis on medical education and commitment from Division faculty and fellows has led to the UCH-MICU rotation receiving consistently high rankings among trainees.
Recovery after hospitalization in the intensive care unit (ICU) can present new challenges for patients. Critical illness contributes to the development of new physical and cognitive impairments often resulting from the illness itself (sepsis, respiratory failure), but also necessary ICU interventions including prolonged bedrest and the use of sedative medications. Further, an ICU stay can exacerbate psychosocial stress, placing ICU survivors at risk for long-term mental health conditions including depression, anxiety and post-traumatic stress disorder. Together, these new physical, cognitive and psychological symptoms observed in patients recovering from critical illness are termed the post-ICU syndrome (PICS). PICS impacts up to 50% of ICU survivors and can adversely affect long-term function for years after the ICU stay. The University of Colorado ICU Recovery Clinic aims to identify and alleviate symptoms of PICS with the expressed goal of improving outcomes for patients after critical illness. The clinic employs a multidisciplinary, consultative model that links patients with necessary services for reducing the burden of PICS. Through collaboration between pulmonary/critical care medicine, physical medicine and rehabilitation, the rehabilitative disciplines (physical, occupational, speech therapy) and psychology/psychiatry services, patients receive an individualized recovery plan tailored to their personal recovery needs. Patients are followed over their course of recovery with necessary support provided when needed across the recovery trajectory. Additionally, the clinic serves as a site of ongoing clinical and translational research in ICU recovery and long-term ICU survivorship.