Principles of Critical Care > Part II. General Management of the Patient > Chapter 18. Chronic Critical Illness Shannon S. Carson

Key Points

"Advances in medical management and technology have greatly enhanced patients' ability to survive critical illness and injury. For most critically ill patients, the clinical course is typified by liberation from organ support systems such as vasoactive drugs and mechanical ventilation after reversal of the acute process, followed by a short period of observation before transfer from the ICU to a medical/surgical ward or an intermediate care unit. For a significant number of patients however, this timely transition to a more stable condition does not occur, and they remain dependent on life support systems or other ICU services for prolonged periods. These patients often are referred to as the chronically critically ill (CCI). As larger proportions of patients are surviving episodes of severe sepsis, acute respiratory distress syndrome (ARDS), multiple trauma, or acute or chronic respiratory failure, CCI patients are becoming a significant component of the practice of critical care medicine...."