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01-12-2003 | Editorial

Optimizing outcomes for older patients treated in the intensive care unit

Author: E. Wesley Ely

Published in: Intensive Care Medicine | Issue 12/2003

Excerpt

Geriatric intensive care is already a very important aspect of our world's healthcare concerns, and it is growing exponentially. In this issue of Intensive Care Medicine, we are fortunate to learn from Somme et al. [1] about the outcomes of older patients (considered by most authors to include those 70–75 years and older) from a well-established critical care program in Paris, France. In this editorial, I will summarize what we have learned about the outcomes of older patients who receive intensive care and consider emerging frontiers both in the intensive care unit (ICU) and during recovery that are of particular importance to successful care of older ICU patients. …

Somme D, Maillet J, Gisselbrecht M, Novara A, Ract C, Fagon JY (2003) Critically ill old and oldest-old patients in intensive care: short- and long-term outcomes. Intensive Care Med (http://dx.doi.org/10.1007/s00134-003-1929-2)

Angus DC, Kelly MA, Schmitz RJ, White A, Popovich J, for the committee on manpower for pulmonary and critical care societies (COMPACCS) (2000) Current and projected workforce requirements for care of the critically ill and patients with pulmonary disease: can we meet the requirements of an aging population? JAMA 284:2762–2770CrossRef

Behrendt CE (2000) Acute respiratory failure in the United States: incidence and 31-day survival. Chest 118:1100–1105CrossRef

Jakob SM, Rothen HU (1997) Intensive care 1980–1995: change in patient characteristics, nursing workload and outcome. Intensive Care Med 23:1165–1170CrossRef

Chelluri L, Grenvik A, Silverstein M (1995) Intensive care for critically ill elderly: mortality, costs, and quality of life. Review of the literature. Arch Intern Med 155:1013–1022CrossRef

Shaw AB (1996) Age as a basis for healthcare rationing. Support for ageist policies. Drugs Aging 9:403–405CrossRef

Fried TR, Bradley EH, Towle VR, Allore H (2002) Understanding the treatment preferences of seriously ill patients. N Engl J Med 346:1061–1066CrossRef

Ely EW, Evans GW, Haponik EF (1999) Mechanical ventilation in a cohort of elderly patients admitted to an intensive care unit. Ann Intern Med 131:96–104CrossRef

Quality of Life after mechanical ventilation in the aged study investigators (2002) Two-month mortality and functional status of critically ill adult patients receiving prolonged mechanical ventilation. Chest 121:549–555CrossRef

10.

Ely EW, Wheeler AP, Thompson BT, Ancuklewicz M, Steinberg KP, Bernard GR (2002) Recovery rate and prognosis in older persons who develop acute lung injury and the acute respiratory distress syndrome. Ann Intern Med 136:25–36CrossRef

11.

Esteban A, Anzueto A, Alia I, Ely EW, Frutos F, Brochard L, et al (2000) Indications for, complications from, and outcome of mechanical ventilation: effect of age. Am J Respir Crit Care Med 161:A385CrossRef

12.

Montuclard L, Garrouste-Orgeas M, Timsit JF, Misset B, Jonghe BD, Carlet J (2000) Outcome, functional autonomy, and quality of life of elderly patients with a long-term intensive care unit stay. Crit Care Med 28:3389–3395CrossRef

13.

Hobbs F, Damon BL, Taeuber CM (1996) Sixty-five plus in the United States. U.S. Department of Commerce, Economics, and Statistics Administration, Bureau of the Census, Washington, DC

14.

Ely EW, Baker AM, Dunagan DP, Burke HL, Smith AC, Kelly PT, et al (1996) Effect on the duration of mechanical ventilation of identifying patients capable of breathing spontaneously. N Engl J Med 335:1864–1869CrossRef

15.

Herridge MS, Cheung AM, Tansey CM, Matte-Martyn A, Diaz-Granados N, Al-Saidi F, et al (2003) One-year outcomes in survivors of the acute respiratory distress syndrome. N Engl J Med 34:683–693CrossRef

16.

Ely EW, Inouye SK, Bernard GR, Gordon S, Francis J, May L, et al (2001) Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU). JAMA 286:2703–2710CrossRef

17.

Ely EW, Margolin R, Francis J, May L, Truman B, Dittus R, et al (2001) Evaluation of delirium in critically ill patients: validation of the confusion assessment method for the intensive care unit (CAM-ICU). Crit Care Med 29:1370–1379CrossRef

18.

Coller Z, Shintani A, Truman B, Thomason J, Milbrandt E, Bernard GR, et al (2003) The impact of delirium in the ICU on outcomes of mechanical ventilation. Am J Respir Crit Care Med (in press)

19.

Ely EW, Gautam S, Margolin R, Francis J, May L, Speroff T, et al (2001) The impact of delirium in the intensive care unit on hospital length of stay. Intensive Care Med 27:1892–1900CrossRef

20.

Ely EW, Shintani A, Bernard G, Jackson J, Gordon S, May L, et al (2002) Delirium in the ICU is associated with prolonged length of stay in the hospital and higher mortality. Am J Respir Crit Care Med 165:A23

21.

Gee MH, Gottleib JE, Albertine KH, Kubis JM, Peters SP, Fish JE (1990) Physiology of aging related to outcome in the adult respiratory distress syndrome. Am Physiol Soc 1:822–829

22.

Luhr QR, Antonsen K, Karlsson M, Aardal S, Thorsteinsson A, Frostell CG, et al (1999) Incidence and mortality after acute respiratory failure and acute respiratory distress syndrome in Sweden, Denmark, and Iceland. Am J Respir Crit Care Med 159:1849–1861CrossRef

23.

Angus D, Musthafa AA, Clermonte G, Griffin MF, Linde-Zwirble WT, Dremsizov TT, et al (2001) Quality-adjusted survival in the first year after the acute respiratory distress syndrome. Am J Respir Crit Care Med 163:1389–1394CrossRef

24.

Hopkins RO, Weaver LK, Pope D, Orme JF, Bigler ED, Larson-Lohr V (1999) Neuropsychological sequelae and impaired health status in survivors of severe acute respiratory distress syndrome. Am J Respir Crit Care Med 160:50–56CrossRef

25.

Marquis KA, Curtis JR, Caldwell ES, Davidson TA, Davis JM, Sanchez P, et al (2000) Neuropsychological sequelae in survivors of ARDS compared with critically ill control patients. Am J Respir Crit Care Med 161:A383

26.

Rothenhausler HB, Ehrentraut S, Stoll C, Schelling G, Kapfhammer HP (2001) The relationship between cognitive performance and employment and health status in long-term survivors of the acute respiratory distress syndrome: results of an exploratory study. Gen Hosp Psychiatry 23:90–96CrossRef

27.

Jackson JC, Hart RP, Gordon SM, Shintani A, Truman B, May L, et al (2003) Six-month neuropsychological outcome of medical intensive care unit patients. Crit Care Med 31:1226–1234CrossRef

28.

Angus DC, Carlet J (2003) Surviving Intensive Care: a report from the 2002 Brussels Roundtable. Intensive Care Med 29:368–377

29.

Hund E (2001) Neurological complications of sepsis: critical illness polyneuropathy and myopathy. J Neurol 248:929–934CrossRef

30.

Fletcher SN, Kennedy DD, Ghosh IR, Misra VP, Kiff K, Coakley JH, et al (2003) Persistent neuromuscular and neurophysiologic abnormalities in long-term survivors of prolonged critical illness. Crit Care Med 31:1012–1016CrossRef

Title: Optimizing outcomes for older patients treated in the intensive care unit
Author: E. Wesley Ely
Publication date: 01-12-2003
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 12/2003
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-003-1845-5

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