Chronic critical illness: are we saving patients or creating victims?

Area of Science:

• Critical Care Medicine
• Intensive Care
• Pulmonology

Background:

• Technological advances improve survival for critically ill patients.
• A subset of survivors develops persistent critical illness (PCI), characterized by prolonged organ dysfunction and inflammation.
• PCI presents unique challenges beyond the acute phase of critical illness.

Purpose of the Study:

• To synthesize current evidence on the definition of persistent critical illness.
• To review the pathophysiology, clinical manifestations, and treatment strategies for PCI.
• To discuss the long-term prognosis and outcomes for patients with PCI.

Main Methods:

• Systematic review of current literature.
• Analysis of diagnostic criteria and epidemiological data.
• Synthesis of research on inflammatory pathways and metabolic alterations.

Main Results:

• Persistent critical illness is defined by prolonged organ dysfunction and inflammatory state post-acute phase.
• Patients with PCI experience extended hospital stays, muscle/bone metabolism changes, immunodeficiency, and cognitive deficits.
• High healthcare resource consumption and long-term mortality are characteristic of PCI.

Conclusions:

• Persistent critical illness represents a distinct clinical entity requiring specific management approaches.
• Further research is needed to optimize treatment and improve outcomes for PCI patients.
• Understanding PCI is crucial for improving long-term quality of life and reducing healthcare burden.