title: Caring for critically ill oldest old patients: a clinical review.
abstract: Despite technological advances, the mortality rate for critically ill oldest old patients remains high. The intensive caring should be able to combine technology and a deep humanity considering that the patients are living the last part of their lives. In addition to the traditional goals of ICU of reducing morbidity and mortality, of maintaining organ functions and restoring health, caring for seriously oldest old patients should take into account their end-of-life preferences, the advance or proxy directives if available, the prognosis, the communication, their life expectancy and the impact of multimorbidity. The aim of this review was to focus on all these aspects with an emphasis on some intensive procedures such as mechanical ventilation, noninvasive mechanical ventilation, cardiopulmonary resuscitation, renal replacement therapy, hemodynamic support, evaluation of delirium and malnutrition in this heterogeneous frail ICU population.
authors.affiliation: Geriatric and Intensive Geriatric Care Ward, Azienda Ospedaliera di Rilievo Nazionale e di Alta Specialità "San Giuseppe Moscati", via Contrada Amoretta, 83100, Avellino, Italy. nicolavargas@tin.it.
authors.forename: Nicola
authors.initials: N
authors.lastname: Vargas
authors.affiliation: Medicine Ward, Medicine Department, "San Giuseppe Moscati" Hospital, via Gramsci, 81031, Aversa, CE, Italy.
authors.forename: Loredana
authors.initials: L
authors.lastname: Tibullo
authors.affiliation: Geriatric and Intensive Geriatric Care Ward, Azienda Ospedaliera di Rilievo Nazionale e di Alta Specialità "San Giuseppe Moscati", via Contrada Amoretta, 83100, Avellino, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Landi
authors.affiliation: Geriatric and Intensive Geriatric Care Ward, Azienda Ospedaliera di Rilievo Nazionale e di Alta Specialità "San Giuseppe Moscati", via Contrada Amoretta, 83100, Avellino, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Carifi
authors.affiliation: Clinical Nutrition and Dietology Unit, Medicine Department, Azienda Ospedaliera di Rilievo Nazionale e di alta Specialità "San Giuseppe Moscati", via Contrada Amoretta, 83100, Avellino, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Pirone
authors.affiliation: Geriatric and Intensive Geriatric Care Ward, Azienda Ospedaliera di Rilievo Nazionale e di Alta Specialità "San Giuseppe Moscati", via Contrada Amoretta, 83100, Avellino, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pippo
authors.affiliation: Geriatric and Intensive Geriatric Care Ward, Azienda Ospedaliera di Rilievo Nazionale e di Alta Specialità "San Giuseppe Moscati", via Contrada Amoretta, 83100, Avellino, Italy.
authors.forename: Immacolata
authors.initials: I
authors.lastname: Alviggi
authors.affiliation: Geriatric and Intensive Geriatric Care Ward, Azienda Ospedaliera di Rilievo Nazionale e di Alta Specialità "San Giuseppe Moscati", via Contrada Amoretta, 83100, Avellino, Italy.
authors.forename: Renato
authors.initials: R
authors.lastname: Tizzano
authors.affiliation: Department of Clinical Disease and Internal Medicine, Federico II University of Naples, via Pansini, 80121, Naples, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Salsano
authors.affiliation: Geriatric and Intensive Geriatric Care Ward, Azienda Ospedaliera di Rilievo Nazionale e di Alta Specialità "San Giuseppe Moscati", via Contrada Amoretta, 83100, Avellino, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Grezia
authors.affiliation: Department of Neuroscience and Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini, 89121, Naples, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Vargas
mesh_terms: D016223:Advance Directives; D000369:Aged, 80 and over; D003142:Communication; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007362:Intensive Care Units; D011379:Prognosis
keywords: Critical care; Intensive geriatric care; Oldest old