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Understanding, recognizing, and managing chronic critical illness syndrome
Ann Bellar1, Kathleen Kunkler, Mary Burkett
1College of Health Professions, University of Detroit Mercy, Detroit, Michigan, USA. bellaran@udmercy.edu
Journal of the American Academy of Nurse Practitioners
|November 11, 2009
Summary
Nurse practitioners (NPs) lack guidelines for chronic critical illness syndrome (CCIS). This article offers the allostasis framework to guide NP understanding and management of CCIS patients with widespread organ damage.
Area of Science:
- Critical care medicine
- Physiology
- Nursing practice
Background:
- Chronic critical illness syndrome (CCIS) affects a growing patient population.
- No evidence-based guidelines currently exist for CCIS care.
- Nurse practitioners (NPs) are increasingly managing CCIS patients.
Purpose of the Study:
- To provide NPs with a physiological framework, allostasis, for understanding CCIS.
- To guide NP management strategies for patients with CCIS.
- To address the unique care needs of CCIS patients.
Main Methods:
- Review of scientific publications.
- Analysis of existing clinical guidelines.
Main Results:
- CCIS patients are distinct from acutely critically ill patients.
- CCIS is characterized by widespread tissue and organ damage.
- Syndrome elements include neuroendocrine issues, malnutrition, infections, and physical/mental impairments.
Conclusions:
- NPs must treat CCIS as a cohort of interrelated elements.
- Focus on re-establishing patient normalcy is crucial.
- The allostasis framework aids in managing CCIS complexity.
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