The long-term ICU patient: Which definition?

Area of Science:

• Critical Care Medicine
• Nursing
• Patient Outcomes

Background:

• Medical advancements increase survival of critically ill patients.
• This leads to a growing population of patients with prolonged intensive care unit (ICU) stays.
• Varied terminology for long-term ICU patients risks unmet needs and care fragmentation.

Approach:

• A discursive review was conducted to explore terminology for long-term ICU patients.
• Literature searches identified seven common terms: prolonged mechanical ventilation, failure to wean, tracheostomy, chronically critically ill, persistent critical illness, persistent inflammatory-immunosuppressive and catabolic syndrome, and frailty.
• A focused literature review examined the nuances of these identified terms.

Key Points:

• Lack of standardized definitions for long-term ICU patients can lead to inadequate care.
• Seven distinct terms are commonly used to describe patients with extended ICU stays.
• Recognizing and defining these terms is essential for patient safety and care planning.

Conclusions:

• Unmet patient needs can arise from unclear definitions of long-term ICU patients.
• Acknowledging and defining this patient group is essential for improving care.
• Standardizing terminology is a priority for enhancing care pathways and patient outcomes.