Snježana Benko, Tomislav Ružman, Nataša Ružman, Nikolina Marić

KB ''Sveti Duh'', Department of Anaesthesia and Intensive Care Unit, Department of Microbiology, Our Lady of Lourdes Hospital, Drogheda, Co Louth (Irska)

critical care medicine, chronic critical patient

''10. Međunarodni kongres HDMSARIST-a''

Šibenik, 20.-23. travnja 2017. godine

Approximately 5-10% of critically ill patients need prolonged critical care treatment after surviving
the acute critical episode. Most of them need prolonged mechanical ventilation and/or
tracheostomy. Agressive intensive care treatment, advanced age and comorbidities are major risk
factors for development of chronic critical illness. Chronic critical illness except prolonged mechanical
ventilation and/or tracheostomy includes severe complications in almost all organs and organ
systems (severe neuromyopathy, metabolic disorders, generalized oedema, pressure sores,
reccurent infections, hormonal changes, emotional changes, etc.). Prolonged specialized care is
associated with high costs for medical equipment and consumable medical supplies. Also, prolonged
critical care is a burden for their families due to economic and emotional issues. Chronic critical
illness becomes a real problem in the all developed world including Croatia. Multidisciplinary
approach is a cornerstone of the care for the chronic critical ill patient and respiratory
physiotherapist should be a team leader in that team. Regular early physiotherapy can improve final
outcome and decrease the number of complications. National service for prolonged critical care
treatment out of acute hospitals and clear guidelines might improve the care for these patients. Long
term home treatment is the best way of care, so it is very important to involve family members early
at the beginning of intensive care treatment, educate and train them for the taking care of sick family
member. Ensuring financial, medical and technical support to the family is important also.

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