Skip to main content
Top
Published in: Critical Care 5/2008

Open Access 01-10-2008 | Research

Intensive care for the adult population in Ireland: a multicentre study of intensive care population demographics

Author: The Irish Critical Care Trials Group

Published in: Critical Care | Issue 5/2008

Login to get access

Abstract

Introduction

This prospective observational study was conducted to describe the nature of the intensive care population across Ireland, identify adherence to international benchmarks of practice, and describe patient outcomes in critically ill patients.

Methods

A prospective observational multicentre study of demographics and organ failure incidence was carried out over a 10-week period in 2006 across the intensive care units (ICUs) of 14 hospitals in both the Republic and Northern Ireland.

Results

In total, there were 1,029 patient episodes entered across 14 ICUs. Emergency admissions accounted for 70% of episodes. Admissions after major elective surgery accounted for 20.5% of admissions. The mean length of ICU stay was 5.7 days, with a median of 2 days. Severe sepsis was identified in 35% of patients during their ICU admission. Mechanical ventilation was used in 70.7% of all patients admitted, of whom 26.9% had acute lung injury. Acute kidney injury occurred in 28% of all patients. Interhospital transfers were undertaken in 85 (8.3%) patients. The overall intensive care mortality of the study population was 19%.

Conclusions

Intensive care medicine in Ireland serves a patient population with high requirement for mechanical ventilation and support of the function of multiple organs. The overall mortality compares favourably with international benchmarks.
Appendix
Available only for authorised users
Literature
2.
go back to reference Vincent JL, Moreno R, Takala J, Willatts S, De Mendonça A, Bruining H, Reinhart CK, Suter PM, Thijs LG: The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive Care Med 1996, 22: 707-710. 10.1007/BF01709751CrossRefPubMed Vincent JL, Moreno R, Takala J, Willatts S, De Mendonça A, Bruining H, Reinhart CK, Suter PM, Thijs LG: The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive Care Med 1996, 22: 707-710. 10.1007/BF01709751CrossRefPubMed
3.
go back to reference American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 1992, 20: 864-874.CrossRef American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 1992, 20: 864-874.CrossRef
4.
go back to reference Bernard GR, Artigas A, Brigham KL, Carlet J, Falke K, Hudson L, Lamy M, Legall JR, Morris A, Spragg R: The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med 1994, 149: 818-824.CrossRefPubMed Bernard GR, Artigas A, Brigham KL, Carlet J, Falke K, Hudson L, Lamy M, Legall JR, Morris A, Spragg R: The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med 1994, 149: 818-824.CrossRefPubMed
5.
go back to reference Uchino S, Bellomo R, Goldsmith D, Bates S, Ronco C: An assessment of the RIFLE criteria for acute renal failure in hospitalized patients. Crit Care Med 2006, 34: 1913-1917. 10.1097/01.CCM.0000224227.70642.4FCrossRefPubMed Uchino S, Bellomo R, Goldsmith D, Bates S, Ronco C: An assessment of the RIFLE criteria for acute renal failure in hospitalized patients. Crit Care Med 2006, 34: 1913-1917. 10.1097/01.CCM.0000224227.70642.4FCrossRefPubMed
6.
go back to reference The Irish Critical Care Trials Group: Acute lung injury and the acute respiratory distress syndrome in Ireland; a prospective audit of epidemiology and management. Crit Care 2008, 12: R30. 10.1186/cc6808PubMedCentralCrossRef The Irish Critical Care Trials Group: Acute lung injury and the acute respiratory distress syndrome in Ireland; a prospective audit of epidemiology and management. Crit Care 2008, 12: R30. 10.1186/cc6808PubMedCentralCrossRef
7.
go back to reference Charles R, Marsh B, Carton E, Power M, Motherway C, Claffey L, Crowley K, Donnelly M, O'Hare B, O'Leary E, Ryan T: Accessibility of intensive care facilities in Ireland to critically ill patients. Ir Med J 2002, 95: 72-74.PubMed Charles R, Marsh B, Carton E, Power M, Motherway C, Claffey L, Crowley K, Donnelly M, O'Hare B, O'Leary E, Ryan T: Accessibility of intensive care facilities in Ireland to critically ill patients. Ir Med J 2002, 95: 72-74.PubMed
9.
go back to reference Annane D, Sébille V, Charpentier C, Bollaert PE, François B, Korach JM, Capellier G, Cohen Y, Azoulay E, Troché G, Chaumet-Riffaut P, Bellissant E: Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA 2002, 288: 862-871. 10.1001/jama.288.7.862CrossRefPubMed Annane D, Sébille V, Charpentier C, Bollaert PE, François B, Korach JM, Capellier G, Cohen Y, Azoulay E, Troché G, Chaumet-Riffaut P, Bellissant E: Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA 2002, 288: 862-871. 10.1001/jama.288.7.862CrossRefPubMed
10.
go back to reference Damas P, Ledoux D, Nys M, Monchi M, Wiesen P, Beauve B, Preiser JC: Intensive care unit acquired infection and organ failure. Intensive Care Med 2008, 34: 856-864. 10.1007/s00134-008-1018-7CrossRefPubMed Damas P, Ledoux D, Nys M, Monchi M, Wiesen P, Beauve B, Preiser JC: Intensive care unit acquired infection and organ failure. Intensive Care Med 2008, 34: 856-864. 10.1007/s00134-008-1018-7CrossRefPubMed
11.
go back to reference Metnitz PG, Fieus F, Jorden B, Lang T, Moreno R, LeGall JR: Critically ill patients readmitted to intensive care units – lessons to learn? Intensive Care Med 2003, 29: 241-248.PubMed Metnitz PG, Fieus F, Jorden B, Lang T, Moreno R, LeGall JR: Critically ill patients readmitted to intensive care units – lessons to learn? Intensive Care Med 2003, 29: 241-248.PubMed
12.
go back to reference Rosenberg AL, Watts C: Patients readmitted to ICUs; a systematic review of risk factors and outcome. Chest 2000, 118: 492-502. 10.1378/chest.118.2.492CrossRefPubMed Rosenberg AL, Watts C: Patients readmitted to ICUs; a systematic review of risk factors and outcome. Chest 2000, 118: 492-502. 10.1378/chest.118.2.492CrossRefPubMed
14.
go back to reference Goldfrad C, Rowan K: Consequences of discharges from intensive care at night. Lancet 2000, 355: 1138-1142. 10.1016/S0140-6736(00)02062-6CrossRefPubMed Goldfrad C, Rowan K: Consequences of discharges from intensive care at night. Lancet 2000, 355: 1138-1142. 10.1016/S0140-6736(00)02062-6CrossRefPubMed
16.
go back to reference Brun-Buisson C, Minelli C, Bertolini G, Brazzi L, Pimentel J, Lewandowski K, Bion J, Romand JA, Villar J, Thorsteinsson A, Damas P, Armaganidis A, Lemaire F, ALIVE Study Group: Epidemiology and outcome of acute lung injury in European intensive care units. Results from the ALIVE study. Intensive Care Med 2004, 30: 51-61. 10.1007/s00134-003-2022-6CrossRefPubMed Brun-Buisson C, Minelli C, Bertolini G, Brazzi L, Pimentel J, Lewandowski K, Bion J, Romand JA, Villar J, Thorsteinsson A, Damas P, Armaganidis A, Lemaire F, ALIVE Study Group: Epidemiology and outcome of acute lung injury in European intensive care units. Results from the ALIVE study. Intensive Care Med 2004, 30: 51-61. 10.1007/s00134-003-2022-6CrossRefPubMed
17.
go back to reference The ARDS Network investigators: Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 2000, 342: 1301-1308. 10.1056/NEJM200005043421801CrossRef The ARDS Network investigators: Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 2000, 342: 1301-1308. 10.1056/NEJM200005043421801CrossRef
18.
go back to reference Abosaif NY, Tolba YA, Heap M, Russell J, El Nahas AM: The outcome of acute renal failure in the intensive care unit according to RIFLE: model application, sensitivity, and predictability. Am J Kidney Dis 2005, 46: 1038-1048. 10.1053/j.ajkd.2005.08.033CrossRefPubMed Abosaif NY, Tolba YA, Heap M, Russell J, El Nahas AM: The outcome of acute renal failure in the intensive care unit according to RIFLE: model application, sensitivity, and predictability. Am J Kidney Dis 2005, 46: 1038-1048. 10.1053/j.ajkd.2005.08.033CrossRefPubMed
19.
go back to reference Uchino S, Bellomo R, Morimatsu H, Morgera S, Schetz M, Tan I, Bouman C, Macedo E, Gibney N, Tolwani A, Oudemans-van Straaten H, Ronco C, Kellum JA: Continuous renal replacement therapy: a worldwide practice survey. The beginning and ending supportive therapy for the kidney (B.E.S.T. kidney) investigators. Intensive Care Med 2007, 33: 1563-1570. 10.1007/s00134-007-0754-4CrossRefPubMed Uchino S, Bellomo R, Morimatsu H, Morgera S, Schetz M, Tan I, Bouman C, Macedo E, Gibney N, Tolwani A, Oudemans-van Straaten H, Ronco C, Kellum JA: Continuous renal replacement therapy: a worldwide practice survey. The beginning and ending supportive therapy for the kidney (B.E.S.T. kidney) investigators. Intensive Care Med 2007, 33: 1563-1570. 10.1007/s00134-007-0754-4CrossRefPubMed
Metadata
Title
Intensive care for the adult population in Ireland: a multicentre study of intensive care population demographics
Author
The Irish Critical Care Trials Group
Publication date
01-10-2008
Publisher
BioMed Central
Published in
Critical Care / Issue 5/2008
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc7018

Other articles of this Issue 5/2008

Critical Care 5/2008 Go to the issue