Patients who need more than 48 hours of mechanical ventilation have a fatality rate of more than 40%.
Greater than 41% of patients requiring ICU care for over 48 hours have microbiologically confirmed infections.
Despite adequate antimicrobial therapy, patients requiring ICU care for more than 48 hours, infections cause significant hemodynamic instability and mortality.
Hospital mortality rate greater than 35% for patients hospitalized in an ICU for more than 48 hours and with a microbiologically confirmed infection.
As many as 1 in 5 people die in an ICU or shortly after having received care in one.
Are frequently at the end of life.
Telemedicine monitoring of Intensive Care unit patients by intensiveness is not associated with overall improvement in length of stay or mortality rates(Thomas EJ).
Gastric mucosal ulcers (stress ulcers), frequently implicated as an underlying cause of nosocomial upper GI bleeding in ICU patients.
Risk factors for nosocomial upper gastrointestinal bleeding include mechanical ventilation, and coagulopathy which have been noted among patients in an ICU (Cook D et al).
Gastric acid suppression can provide effective prophylaxis against upper GI bleeds in ICU patients (Cook D et al).
A flexible family visiting program did not significantly reduce the incidence of delirium among patients in the ICU.
Survivors of an ICU can experience a variety of mental health disorders:
Anxiety, depression, posttraumatic stress disorder, and complicated grief for families.
For most patients and their families ICU admission is an unanticipated event that causes psychological distress.
Consequences of ICU stay include: delirium, anxiety, depression, and acute and post traumatic stress disorder.
Psychological consequences of an ICU stay may be exacerbated by delusions experienced during delirium which is common in critically ill patients and has an adverse effect on physical and cognitive function and leads to increased healthcare use and costs.
Families of patients in the ICU experience anxiety and acute stress arising from uncertainty regarding the prognosis of their family member.
Long-term psychological effects in family members are similar to those experienced by patients themselves.
In critically ill patients admitted to an ICU, hyperglycemia is common and is associated with a poor outcome.
In ICU patients metabolic responses are proportional to the severity of the injury/illness.
During an acute phase of critical illness, energy expenditure is reduced, and macronutrient metabolism is altered to provide glucose to vital organs, such as the heart, brain and red blood cells.
With acute critical illness, endogenous glucose production is elevated and increases in glucose turnover occurs in the liver, intestine and kidneys.
During the acute process excessive protein breakdown occurs with overactivation of the ubiquitin-proteasome pathway.
During the first week of critical illness muscle wasting occurs and is more severe with multiorgan failure than in those with single organ failure.
Amino acids, derived from protein catabolism are the main substrates of hepatic gluconeogenesis, but are diverted during critical illness to produce acute phase proteins.
In late phase, acute critical illness there’s an increase in oxygen consumption and energy expenditure with ongoing tissue breakdown, providing substrate to preserve critical organ function.
During a recovery phase, metabolic response is normalized and protein, and fat stores are gradually replenished.