Chronic disease Archives - Critical Care Science (CCS)

  • Review Articles

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

    Rev Bras Ter Intensiva. 2017;29(1):87-95

    Abstract

    Review Articles

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

    Rev Bras Ter Intensiva. 2017;29(1):87-95

    DOI 10.5935/0103-507X.20170013

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    ABSTRACT

    The technological advancements that allow support for organ dysfunction have led to an increase in survival rates for the most critically ill patients. Some of these patients survive the initial acute critical condition but continue to suffer from organ dysfunction and remain in an inflammatory state for long periods of time. This group of critically ill patients has been described since the 1980s and has had different diagnostic criteria over the years. These patients are known to have lengthy hospital stays, undergo significant alterations in muscle and bone metabolism, show immunodeficiency, consume substantial health resources, have reduced functional and cognitive capacity after discharge, create a sizable workload for caregivers, and present high long-term mortality rates. The aim of this review is to report on the most current evidence in terms of the definition, pathophysiology, clinical manifestations, treatment, and prognosis of persistent critical illness.

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

    Palliative care of elderly patients in intensive care units: a systematic review

    Rev Bras Ter Intensiva. 2012;24(2):197-206

    Abstract

    Review Articles

    Palliative care of elderly patients in intensive care units: a systematic review

    Rev Bras Ter Intensiva. 2012;24(2):197-206

    DOI 10.1590/S0103-507X2012000200017

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    OBJECTIVE: The use of interventionist medical technology in terminal elderly patients must be associated with palliative care as a measure of clinical support in intensive care units. Palliative care is an important component of end-of-life care, and the assistance provided by the healthcare team should be guided by decisions made by patients and their family members. Prolongation of life not accompanied by therapies aimed at relieving symptoms, such as pain and dyspnea, contributes to patient and family member stress suffering. The aim of the present study was to survey advances made in the application of palliative care in intensive care units. METHODS: Medline and Bireme were used to perform a systematic literature review of intensive care units-based palliative care for elderly patients. RESULTS: A total of 29 articles describing palliative care in intensive care units were analyzed according to the variables "satisfaction of relatives when they participate in the discussions on palliative care" and "difficulties to implement such type of care due to lack of technical skills of the health caregivers." CONCLUSION: Palliative care for elderly patients in intensive care units must be more thoroughly investigated to improve the relationships and communication among patients, their relatives, and the healthcare team. As greater numbers of elderly patients are admitted to intensive care units, the skills of health caregivers must improve to meet the challenges posed by the end-of-life care.

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    Palliative care of elderly patients in intensive care units: a systematic review

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