Athersys, Inc. · OTC:ATHXQ
Athersys — Free Educational Webinar - Lessons Learned from COVID-19 and ARDS: Recovery and Life After (December 2020)
54 slides from Athersys's conference presentation, Dec 1, 2020
Slide 1: Educational Webinar for ARDS ICU Patients, Survivors and Families
Educational Webinar for ARDS ICU Patients, Survivors and Families Lessons Learned from COVID-19 and ARDS: Recovery and Life After the ICU
Slide 2: Agenda
Agenda • Mission of the ARDS Foundation o Ms. Eileen Rubin • Acute Respiratory Distress Syndrome (ARDS), COVID-19 and the Burden of Critical Illness o Dr. Joshua Veith • Post-Intensive Care Syndrome and the Road to Recovery o Dr. Michelle Biehl • A Patient’s Perspective – Surviving ARDS and COVID-19
Slide 3: Thank you to our Sponsor
Thank you to our Sponsor Committed to developing therapies to extend and enhance the quality of human life.
Slide 4: Eileen Rubin, J.D. President/CEO ARDS Foundation
Eileen Rubin, J.D. President/CEO ARDS Foundation ArdsFoundation.org
Slide 5: ARDS Survivor
ARDS Survivor • In 1995, active 33 years old attorney • Suddenly admitted to Intensive Care Unit • 2 days later, in respiratory distress, on mechanical ventilator • In a drug induced coma for 4 weeks • On the ventilator for 8 weeks • In the hospital for 9 weeks
Slide 6: ARDS Lungs
ARDS Lungs FOUNDATION
Slide 7: Hospital Complications
Hospital Complications • Both lungs collapsed twice; 5 chest tubes • Suffered fluid overload • Doctors wanted to ‘pull the plug’ at 2 weeks; almost died five times • Nearly deadly hospital acquired infection in trach • Vent dependent • Experienced severe delirium
Slide 8: 5 years later, ARDS Foundation
5 years later, ARDS Foundation • Supply support for those with horrific diagnosis of ARDS • Provide Educational Materials • Offer Informational Materials • Raise awareness of ARDS • Facilitated Medical Research of ARDS
Slide 9: ARDS Foundation mission
ARDS Foundation mission • To provide a forum where those in the ARDS Community can not only connect with one another but also to learn about ongoing research as well as to connect with those in the medical community with questions and receive answers • To share the stories about ARDS and the acute r
Slide 10: Patient Engagement
Patient Engagement • Patients and families want to be included as part of the care team • Working together as allies. • Humanization in the ICU results in reduced patient anxiety, apprehension and fear • ARDS Foundation educates, supports, empowers • Increase trust of patient and family with medical
Slide 11: COVID-19 and ARDS
COVID-19 and ARDS FOUNDATION
Slide 12: CoVID and ARDS
CoVID and ARDS • In the United States there have been over 250,000 deaths due to CoVID in 2020. The majority of these deaths attributable to CoVID as a preconditioning cause result in ARDS, where ARDS is that which causes the death of the patient. • Prior to 2020, about 200,000 people were affected
Slide 13: Cleveland Clinic
Cleveland Clinic • Cleveland Clinic is ranked as one of the nation’s top hospitals by U.S. News and World Reports in 2020-2021 • Cleveland Clinic’s mission is to provide better care of the sick, investigate their problems and to further the education of those who serve • The vision of Cleveland Clin
Slide 14: Athersys
Athersys • Athersys is an international regenerative medicine company that is committed to the development of therapies to extend and enhance the quality of human life • Athersys’ main focus is on treating critical care indications, such as ARDS, where the current standard of care is limited or inad
Slide 15: Thank You!
Thank You! FOUNDATION We're Fighting For Every Breath.
Slide 16: Acute Respiratory Distress Syndrome (ARDS), COVID-19 and the Burden of Critical Illness
Acute Respiratory Distress Syndrome (ARDS), COVID-19 and the Burden of Critical Illness Dr. Joshua M. Veith Critical Care Physician and Pulmonologist, Cleveland Clinic Staff Member, Cleveland Clinic Post-ICU Recovery Clinic
Slide 17: Welcome!
Welcome! • A moment of thanks
Slide 18: Outline
Outline • Welcome • A Patient’s Journey with Critical Illness • Acute respiratory distress syndrome (ARDS) • COVID-19 • Introduction to post-intensive care syndrome (PICS)
Slide 19: A Patient's Journey with Critical Illness
A Patient’s Journey with Critical Illness 6 million 5.1 million Angus Intensive Care Med 2003;29:368–377 Barrett 2011 HCUP Statistical Brief # 185; December 2014 Weiss 2012 HCUP Statistical Brief # 180; 2014
Slide 20: Acute Respiratory Failure
Acute Respiratory Failure • Over half of patients admitted to the Intensive Care Unit suffer from acute respiratory failure • Acute respiratory failure may develop into a severe, life-threatening form respiratory failure referred to as Acute Respiratory Distress Syndrome (ARDS) Vincent Chest. 2002;1
Slide 21: Acute Respiratory Distress Syndrome (ARDS)
Acute Respiratory Distress Syndrome (ARDS) • Historically, ARDS affects 190,000 patients annually in the United Stated • Many medical conditions can lead to the development of ARDS including: • Pneumonia, sepsis, aspiration, trauma and pancreatitis (list not comprehensive) • ARDS patients account fo
Slide 22: ARDS Treatment: Supportive ICU Care
ARDS Treatment: Supportive ICU Care Treat the underlying cause of ARDS Extracorporal Lung membrane protective oxygenation ventilation (ECMO)* ARDS Neuromuscul ABCDEF ar blockade Bundle (Paralysis)* Prone positioning ventilation* *in select patients
Slide 23: ABCDEF Bundle
ABCDEF Bundle https://www.sccm.org/ICULiberation/ABCDEF-Bundles
Slide 24: Coronavirus disease 2019 (COVID-19)
Coronavirus disease 2019 (COVID-19) • Novel coronavirus was identified as the cause of Dec 2019 pneumonia cases in Wuhan, a city in the Hubei Province of China • World Health Organization designated the disease Feb 2020 COVID-19 • World Health Organization declared COVID-19 Mar 2020 a pandemic
Slide 25: COVID-19 and ARDS
COVID-19 and ARDS Location COVID-19 Statistics United States >13 million cases Ohio 414,432 cases 26,507 hospitalizations 4,644 ICU admissions • Many COVID-19 ICU patients develop ARDS • The majority will become ARDS survivors https://covid.cdc.gov/covid-data-tracker/#cases_casesper100klast7days htt
Slide 26: A Patient's Journey with Critical Illness
A Patient’s Journey with Critical Illness Post-Intensive Care Syndrome (PICS) Angus Intensive Care Med 2003;29:368–377
Slide 27: Post-Intensive Care Syndrome (PICS)
Post-Intensive Care Syndrome (PICS) • Defined as new or worsening impairment after critical illness in one or more of the following domains: cognition, mental, or physical health • 50% or more of ICU survivors suffer from one or more component of PICS • The unfortunate truth: • Long-term impairment
Slide 28: Thank You!
Thank You! Joshua M. Veith, MD Post-ICU Recovery Clinic: Telephone: (216)445-6937 E-mail: icurecovery@ccf.org
Slide 29: Post-Intensive Care Syndrome and the Road to Recovery
Post-Intensive Care Syndrome and the Road to Recovery Dr. Michelle Biehl Critical Care Physician and Pulmonologist, Cleveland Clinic Medical Director, Cleveland Clinic Post-ICU Recovery Clinic
Slide 30: Outline
Outline • Post-Intensive Care Syndrome (PICS) • Post-ICU Interventions and Recovery Programs • Cleveland Clinic Post-ICU Recovery Clinic
Slide 31: Post-Intensive Care Syndrome (PICS)
Post-Intensive Care Syndrome (PICS) Needham DM et al. Crit Care Med 2012 Vol 40 No 2
Slide 32: Post-Intensive Care Syndrome
Post-Intensive Care Syndrome Mental Physical Impairment Health/Emotional Cognitive Impairment Disturbances • Muscular weakness • Anxiety • Memory difficulties • Fatigue • Depression • Attention • Difficulty breathing • Post-traumatic stress • Decision making • Impaired exercise disorder • Executive
Slide 33: Recovery after Critical Illness
Recovery after Critical Illness
Slide 34: Post-ICU Recovery: Interventions
Post-ICU Recovery: Interventions Post-ICU Peer support recovery groups for programs patients and families Cognitive Early therapy rehabilitation Early ICU diary and psychological its debrief intervention Open visitation Brown S et al. AnnalsATS Vol 16 No 8 2019 Azoulay et al. Critical Care. (2017) 2
Slide 35: Post-ICU Recovery Programs
Post-ICU Recovery Programs • Patients and families experience unmet needs after hospital discharge • Post-discharge care is fragmented • Most of the PICS impairments go undiagnosed or are inadequately treated • There is a shared interest by patients, families, clinicians and healthcare systems in im
Slide 36: Brown S et al. AnnalsATS Vol 16 No 8 2019
Brown S et al. AnnalsATS Vol 16 No 8 2019
Slide 37: Cleveland Clinic Post-ICU Recovery Clinic (PIRC)
Cleveland Clinic Post-ICU Recovery Clinic (PIRC) • Goal: To provide holistic medical care to ICU survivors, utilizing an interdisciplinary team approach, in order to promote wellness, encourage healing, and support return to the best state of recovery possible
Slide 38: Cleveland Clinic Post-ICU Recovery Clinic (PIRC)
Cleveland Clinic Post-ICU Recovery Clinic (PIRC) Dec 2019 – present Cleveland Clinic Main Campus Pulmonary Clinic Weekly; 1st visit at 2-4 weeks post-hospital discharge Interdisciplinary team approach
Slide 39: Interdisciplinary Team Approach
Interdisciplinary Team Approach Critical Care Physician and APP Case Pharmacy Manager ICU Survivor Respiratory Behavioral Therapy Health Physical Therapy
Slide 40: The PIRC Team
The PIRC Team MD CC physicians: Drs. Michelle Biehl, Eileen Bishop, Karna Sarin, Joshua Veith Physical Therapist: Julie Majcher CC APPs: Maria Holztrager, PA, Jill O’Brien, PA, Kathryn Bash, NP Respiratory Therapists: Scott Marlow, Leslie Patzwahl Behavioral Health/Psychiatrists: Drs. Leo Pozuelo, E
Slide 41: Cleveland Clinic Post-ICU Recovery Clinic
Cleveland Clinic Post-ICU Recovery Clinic Inclusion Criteria Exclusion Criteria • -Shock (requiring vasopressor) • -Hospice care -ARDS -Significant cognitive -Mechanical Ventilation >= 3 impairment days -Prolonged ICU stay (>= 7 days) -Delirium present during ICU stay -Cardiac arrest -COVID-19 with
Slide 42: PIRC Clinic Workflow
PIRC Clinic Workflow Tests and Respiratory Physical Therapy Surveys Therapy Medical Critical Care Psychiatry Assistant Physician Critical Care Pharmacy Advance Referrals Practice Provider
Slide 43: PIRC Clinic Workflow
PIRC Clinic Workflow Tests and Medical Pharmacy Surveys Assistant • Tests: • Vital signs • Thorough • 6 Min Walk Test • Safety questions medication • Pulmonary Function Test reconciliation • CXR • Immunizations • Surveys • Smoking, alcohol, • Functional status and drug use QOL • Anxiety and depressi
Slide 44: PIRC Clinic Workflow
PIRC Clinic Workflow Critical Care Psychiatry Physical Team Therapy • ICU debrief • Evaluation of Anxiety • Evaluation of • Transition to home • Depression strength, balance, gait • ICU survivorship • PTSD • Evaluate for Physical • Complete History • Cognitive function Therapy referral and Physical
Slide 45: PIRC Clinic Workflow
PIRC Clinic Workflow Respiratory Therapist Critical Care Referrals Team • Education on inhalers and • Summary of • Neurology/Brain respiratory recommendations from the Health Center treatments team • Occupational Therapy • Airway clearance • Evaluation of return to work • Speech Language • Tracheost
Slide 46: Cleveland Clinic Post-ICU Recovery Clinic Experience
Cleveland Clinic Post-ICU Recovery Clinic Experience • December 2019- One year experience December 2020 76 unique patients • 47 (62%) post COVID-19 seen • 29 (38%) other diagnosis • 40 (53%) virtual visit Visit type • 36 (47%) in-person
Slide 47: In Summary
In Summary • ICU survivors, specially ARDS survivors, and COVID-19 survivors, are at increased risk of post-intensive care syndrome (PICS) • Without appropriate recognition, PICS impairments go undiagnosed, can persist for months to years and affect profoundly patients’ lives • The comprehensive app
Slide 48: Words of Encouragement to Patients and their Families
Words of Encouragement to Patients and their Families • The road to recovery is long, embrace the journey • Educate yourself, be engaged, take responsibility of yourself and of your health • Focus and be grateful for what you can do, and not what you can’t do • Fear will leave you paralyzed • It’s o
Slide 49: Thank You!
Thank You! Michelle Biehl, M.D., M.S. Post-ICU Recovery Clinic Telephone: (216)445-6937 E-mail: icurecovery@ccf.org
Slide 50: A Patient's Perspective: Surviving ARDS and COVID-19
A Patient’s Perspective: Surviving ARDS and COVID-19 Ms. Alecia Prince-Turner COVID-19, ARDS and ICU Survivor
Slide 51: Q&A Session
Q&A Session Dr. Michelle Biehl, Critical Care Physician and Pulmonologist, Medical Director, Cleveland Clinic Post-ICU Recovery Clinic Dr. Eileen Bishop, Critical Care Physician, Cleveland Clinic Dr. Karna Sarin, Critical Care Physician, Cleveland Clinic Dr. Joshua Veith, Critical Care Physician and
Slide 52: Call to Action: ARDS Foundation
Call to Action: ARDS Foundation Eileen Rubin, J.D. President, ARDS Foundation
Slide 53: Call to Action
Call to Action • Continued medical research of ARDS • Public awareness of acute respiratory distress syndrome • Information and educational materials for the ARDS community • ARDS public awareness to facilitate greater understanding • Patient engagement
Slide 54: Thank You for Attending and Thank You to our Sponsor
Thank You for Attending and Thank You to our Sponsor Committed to developing therapies to extend and enhance the quality of human life.