Chronic critical illness: the growing challenge to health care.
The chronically critically ill (CCI) comprise a rapidly growing population of patients who have survived acute critical illness, only to be left with ongoing organ dysfunctions requiring high levels of specialized care for months or years. In many ways, CCI is an "iatrogenic"  process, reflecting the ability of modern life support technologies to keep patients alive for prolonged periods of time despite ongoing life threatening illness. Venues of care for the CCI patient include acute care hospitals (both ICU and step-down facilities), specialized long term acute  care hospitals, and, less commonly, skilled nursing facilities, or even the home. Importantly, CCI patients transition among these venues frequently, reflecting the nature of CCI to be punctuated with episodes of acute critical illness. Management of the CCI population requires a special combination  of intensive care and rehabilitative skills.
Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA. neil.macintyre@duke.edu
Neil R
NR
Macintyre
D000208:Acute Disease; D002908:Chronic Disease; D003422:Critical Care; D016638:Critical Illness / Q000191:economics / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D018529:Nutritional Support; D010166:Palliative Care; D010523:Peripheral Nervous System Diseases / Q000628:therapy; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000628:therapy; D012121:Respiration, Artificial; D017741:Survivors