Review article
Chronic Critical Patient: A challenge for modern Critical Care Medicine
Tomislav Ružman
; 1Department of Anaesthesia and Intensive Care Unit, Our Lady of Lourdes Hospital, Drogheda, Co Louth, Ireland
Nataša Ružman
; 3Department of Microbiology, Our Lady of Lourdes Hospital, Drogheda, Co Louth, Ireland
Snježana Benko
; 4Department of physical medicine and rehabilitation, Clinical Hospital „Sveti Duh“, Zagreb, Croatia
Nikolina Marić
; 5Intensive Care Unit, Clinical Hospital „Sveti Duh“, Zagreb, Croatia
Abstract
Introduction: Cronic critical patients need long term care
and multidiscilinary approach.
Aim: To show clinical features of chronic critical illness
and possible solutions for long term care.
Materials and methods: Electronic searches of literature
using words related to critical illness, chronic disease,
physiotherapy.
Results: Most of critically ill patients need prolonged
mechanical ventilation and/or tracheostomy. Agressive
intensive care treatment, advanced age and comorbidities
are major risk factors for development of chronic
critical illness. Chronic critical illness except prolonged
mechanical ventilation and/or tracheostomy includes
severe complications in almost all organs and organ
systems (severe neuromyopathy, metabolic disorders,
generalized oedema, pressure sores, reccurent infections,
hormonal changes, emotional changes, etc.). Prolonged
specialized care is associated with high costs for
medical equipment and consumable medical supplies.
Also, prolonged critical care is a burden for their families
due to economic and emotional issues.
Conclusion: Chronic critical illness becomes a real problem
in the all developed world including Croatia. Multidisciplinary
approach is a cornerstone of the care for the
chronic critical ill patient and respiratory physiotherapist
should be a team leader in that team. Regular early
physiotherapy can improve fi nal outcome and decrease
the number of complications. National service for prolonged
critical care treatment out of acute hospitals
and clear guidelines might improve the care for these
patients. Long term home treatment is the best way of
care, so it is very important to involve family members
early at the beginning of intensive care treatment, educate
and train them for the taking care of sick family
member. Ensuring fi nancial, medical and technical support
to the family is important also.
Keywords
critical illness; chronic disease; physiotherapy
Hrčak ID:
183275
URI
Publication date:
25.5.2017.
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