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In-hospital recovery from critical illness 

In-hospital recovery from critical illness
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date: 26 February 2020

Chronic critical illness (CCI) is common and describes a state of prolonged critical illness, in which patients have persisting organ failures requiring treatment in an intensive care setting. There are many different definitions of CCI, with most including prolonged (> 96 hours) mechanical ventilation. Advanced age, higher severity of illness, and poor functional status prior to critical illness are all important risk factors, but prediction of CCI is imperfect. Although requirement for mechanical ventilation is the hallmark, CCI encompasses much more than the respiratory system, with effects on metabolism, skin, brain, and neuromuscular function. During CCI, patients have a high burden of symptoms and impaired capacity to communicate their needs. Mortality and quality of life are generally poor, but highly variable, with 1-year mortality over 50% and most survivors suffering permanent cognitive impairment and functional dependence. Patients at highest and lowest risk for mortality can be identified using a simple prediction rule. Caring for the chronically critically ill is a substantial burden both to patients’ families and to the health care system as a whole. Further research is needed in order to improve care and outcomes for CCI patients and their families.

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