Patient and Population-Level Approaches to Persistent Critical Illness and Prolonged Intensive Care Unit Stays

Theodore J Iwashyna; Elizabeth M Viglianti

doi:10.1016/j.ccc.2018.06.001

Patient and Population-Level Approaches to Persistent Critical Illness and Prolonged Intensive Care Unit Stays

Crit Care Clin. 2018 Oct;34(4):493-500. doi: 10.1016/j.ccc.2018.06.001. Epub 2018 Aug 10.

Authors

Theodore J Iwashyna¹, Elizabeth M Viglianti²

Affiliations

¹ Department of Internal Medicine, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI, USA; Veterans Affairs Center for Clinical Management Research, 2800 Plymouth Drive, Building 16, 3rd floor, Ann Arbor, MI, USA; Institute for Social Research, 426 Thompson St, Ann Arbor, MI 48104, USA. Electronic address: tiwashyn@umich.edu.
² Division of Pulmonary and Critical Care, Department of Internal Medicine, University of Michigan, 3916 Taubman Center, 1500 East Medical Center Drive, SPC 5360, Ann Arbor, MI 48109-5360, USA.

Abstract

The differential diagnosis of prolonged intensive care unit (ICU) stays includes intrinsic patient and admitting diagnostic characteristics, occurrences during the course of critical illness, and system failures. Existing data suggest that the most common cause of prolonged ICU stay is the development of new cascading problems, which is now more related to ongoing critical illness than the original reason for ICU admission. Accepting the dynamism inherent in such a clinical course has implications for contemporary clinical care.

Keywords: Chronic critical illness; ICU; Persistent critical illness; Prolonged length of stay; Prolonged mechanical ventilation.

Published by Elsevier Inc.

Publication types

Review

MeSH terms

Critical Care / methods*
Critical Illness / epidemiology
Critical Illness / therapy*
Diagnosis, Differential
Humans
Intensive Care Units / organization & administration*
Length of Stay*
Time Factors

Abstract

Publication types

MeSH terms

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