Prolonged Stay in Intensive Care Unit

Abstract

Less than 10% of patients admitted to intensive care unit (ICU) have a prolonged stay, defined by a length of stay longer than 14 days. These patients are mainly admitted for acute respiratory distress syndrome, shock or polytraumatism. Their prolonged durations of stay and mechanical ventilation appear closely linked. Their ICU and in-hospital mortality rates are reported as high, although their 1-year quality of life seems relatively satisfactory, because often perceived as better than that suggested by their true functional status. Once stabilized, the objective of the patient management, whose ICU stay is prolonged mainly due to ventilator dependence, should be to initiate their autonomy, recovery and rehabilitation as soon as possible. A particular attention should be given to the neuropsychological status as an intense suffering is frequently underestimated, albeit often observed. The prevention is based on simple measures favoring the well-being of the patient and its family. Finally, specialized weaning or post-ICU units could be considered as interesting and relevant facilities to carry on cares more adapted to patient needs in a safe environment, and resulting in improved capacity of admission to the ICU, as well as reduction in the economic impact related to prolonged stays.