Abstract
The chronically critically ill (CCI) comprise a rapidly growing population of patients who have survived acute critical illness, only to be left with ongoing organ dysfunctions requiring high levels of specialized care for months or years. In many ways, CCI is an “iatrogenic” process, reflecting the ability of modern life support technologies to keep patients alive for prolonged periods of time despite ongoing life threatening illness. Venues of care for the CCI patient include acute care hospitals (both ICU and step-down facilities), specialized long term acute care hospitals, and, less commonly, skilled nursing facilities, or even the home. Importantly, CCI patients transition among these venues frequently, reflecting the nature of CCI to be punctuated with episodes of acute critical illness. Management of the CCI population requires a special combination of intensive care and rehabilitative skills.
- chronic critical illness
- mechanical ventilation
- critical illness
- acute care
- intensive care
- ICU
- step-down
- long-term acute care
- skilled nursing facilities.
Footnotes
- Correspondence: Neil R MacIntyre MD FAARC, Division of Pulmonary and Critical Care Medicine, Duke University Hospital, Box 3911, Durham NC 27710. E-mail: neil.macintyre{at}duke.edu.
This paper was derived from presentations at the 49th Respiratory Care Journal Conference, “The Chronically Critically Ill Patient,” held September 9–10, 2011, in St Petersburg, Florida.
Dr MacIntyre has disclosed a relationship with CareFusion and Trudell Medical.
- Copyright © 2012 by Daedalus Enterprises Inc.