Chronic critical illness is a disease state which affects

intensive care Intensive care medicine, usually called critical care medicine, is a medical specialty that deals with seriously or critically ill patients who have, are at risk of, or are recovering from conditions that may be life-threatening. It includes p ...

patients who have survived an initial insult but remain dependent on intensive care for a protracted period, neither dying nor recovering.Girard K, Raffin TA. The chronically critically ill: to save or let die? ''Respir Care''. 1985; 30: 339-47. The most characteristic clinical feature is a prolonged requirement for

mechanical ventilation Mechanical ventilation or assisted ventilation is the Medicine, medical term for using a ventilator, ventilator machine to fully or partially provide artificial ventilation. Mechanical ventilation helps move air into and out of the lungs, wit ...

.Nelson JE, Cox CE, Hope AA, Carson SS. Chronic critical illness. ''Am J Respir Crit Care Med''. 2010; 182(4): 446-54. Other features include profound weakness associated with critical illness polyneuropathy and

myopathy In medicine, myopathy is a disease of the muscle in which the muscle fibers do not function properly. ''Myopathy'' means muscle disease ( Greek : myo- ''muscle'' + patheia '' -pathy'' : ''suffering''). This meaning implies that the primary defec ...

, increased susceptibility to infection,

metabolic Metabolism (, from ''metabolē'', "change") is the set of life-sustaining chemical reactions in organisms. The three main functions of metabolism are: the conversion of the energy in food to energy available to run cellular processes; the ...

changes and

hormonal A hormone (from the Greek participle , "setting in motion") is a class of signaling molecules in multicellular organisms that are sent to distant organs or tissues by complex biological processes to regulate physiology and behavior. Hormones a ...

changes. There may be protracted or permanent

delirium Delirium (formerly acute confusional state, an ambiguous term that is now discouraged) is a specific state of acute confusion attributable to the direct physiological consequence of a medical condition, effects of a psychoactive substance, or ...

, or other marked cognitive impairment. The physical and psychological symptoms of the disease are very severe, including a propensity to develop

post traumatic stress syndrome Post, POST, or posting may refer to: Postal services * Mail, the postal system, especially in Commonwealth of Nations countries **An Post, the Irish national postal service **Canada Post, Canadian postal service **Deutsche Post, German postal s ...

.Nelson JE, Meier DE, Litke A, Natale DA, Siegel RE, Morrison RS. The symptom burden of chronic critical illness. ''Crit Care Med''. 2004; 32(7): 1527-34. Strict definitions of chronic critical illness vary. One definition is the requirement for mechanical ventilation for 21 days or more. It is estimated that 5-10% of patients who require mechanical ventilation as part of their initial illness will go on to develop chronic critical illness. Overall prevalence has been estimated at 34.4 per 100 000 of the population.Kahn JM, Le T, Angus DC, Cox CE, Hough CL, White DB et al. The epidemiology of chronic critical illness in the United States. ''Crit Care Med''. 2005; 43(2): 282-7. Most adult patients do not survive chronic critical illness, and furthermore even those who are discharged from hospital frequently die soon after discharge. One-year mortality in adults is 48-68%. However, children fare better with two-thirds surviving to 5 years or beyond. Namachivayam SP, Alexander J, Slater A, Millar J, Erickson S, Tibballs J et al. Five-Year Survival of Children With Chronic Critical Illness in Australia and New Zealand ''Crit Care Med''. 2015; 43(9): 1978-85.

References

{{Portal bar, Medicine * Delirium

See also

References