Management of the Patient with Chronic Critical Illness - Part 1: This is part one of a two part series. Part two will be published in September

Arkadiy Finn; Vijairam Selvaraj; Elijah Peterson; Debasree Banerjee; Amos Lal; Himmat Grewal; Edward Martin; Kwame Dapaah-Afriyie

doi:10.55729/2000-9666.1065

Management of the Patient with Chronic Critical Illness - Part 1: This is part one of a two part series. Part two will be published in September

J Community Hosp Intern Med Perspect. 2022 Jul 4;12(4):28-33. doi: 10.55729/2000-9666.1065. eCollection 2022.

Authors

Arkadiy Finn¹, Vijairam Selvaraj¹, Elijah Peterson², Debasree Banerjee³, Amos Lal⁴, Himmat Grewal⁵, Edward Martin⁶, Kwame Dapaah-Afriyie¹

Affiliations

¹ Division of Hospital Medicine, Department of Medicine, Warren Alpert School of Medicine at Brown University, Providence, RI, USA.
² Bryn Mawr College, Bryn Mawr, PA, USA.
³ Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Warren Alpert School of Medicine at Brown University, Providence, RI, USA.
⁴ Division of Pulmonary and Critical Care, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
⁵ Division of Pulmonary and Critical Care, Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA.
⁶ Division of Geriatrics and Palliative Medicine, Department of Medicine, Warren Alpert School of Medicine at Brown University, Providence, RI, USA.

Abstract

Patients with chronic critical illness (CCI) represent a growing segment of the hospitalized population. Key aspects of care in CCI patients including tracheostomy, prolonged mechanical ventilation, nutritional support, wound care, and others require a comprehensive, goal-directed approach. Infectious complications of CCI including pneumonia, tracheobronchitis and urinary tract infection may be caused by nosocomial organisms requiring awareness and adjustment of treatment regimen. Finally, psychiatric, palliative, rehabilitative components of care impact heavily upon outcomes in CCI patients. As care that is typically associated with the intensive care unit is extended to the hospital ward, we aim to increase awareness among providers and outline a systematic approach to deliver high quality, patient centered care to CCI patients.

Keywords: CCI; Chronic critical illness; Chronic illness; LTACH; Medically complex patients; Persistent critical illness.

Publication types

Review