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Intensive Care Medicine (Critical Care Medicine) Print E-mail

Dr. Kennedy Intensive Care Medicine (aka Critical Care Medicine) is concerned with the provision of life support for patients who are critically ill and who require intensive monitoring. Patients requiring intensive care usually require support for maintenance of blood pressure, open airway or respiratory systems (perhaps using ventilator support), acute kidney failure, prevention of dangerous cardiac arrhythmias, and sometimes even the prevention of the cumulative effects of multiple organ system failure. Patients admitted who do not require support for the above reasons are usually admitted for the crucial hours after major surgery when they may be too unstable to transfer to a less intensively monitored unit.

The provision of intensive care is administered in a specialized unit of a hospital called the Intensive Care Unit (ICU) or Critical Care Unit (CCU). Many hospitals also have intensive care units for specialities of medicine, such as the Coronary Care Unit (CCU) for heart disease, Medical Intensive Care Unit (MICU), Surgical Intensive Care Unit (SICU), Pediatric Intensive Care Unit (PICU), Neuroscience Critical Care Unit (NCCU), Overnight Intensive Recovery (OIR), Shock/Trauma Intensive Care Unit (STICU), Neonatal Intensive Care Unit (NICU), and other units as dictated by the needs of each hospital. In the early 1960s, it was not clear that specialized intensive care units were needed, so intensive care resources were administered in the patient's own hospital room. It soon became clear that a fixed location where intensive care resources and personnel were available provided better care than ad hoc provision of intensive care services throughout a hospital.

Common equipment in an intensive care unit includes mechanical ventilators to assist breathing through with endotracheal tube or a tracheotomy; treatment of blood with hemofiltration equipment for acute renal failure; monitoring equipment; intravenous lines for drug infusions, fluids or total parenteral nutrition (TPN), nasogastric (NG) tubes, suction pumps, drains and catheters; and a wide variety of drugs including inotropes to strengthen the acutely failing heart, sedatives for the agitated patient, broad spectrum antibiotics and analgesics.

Intensive care is only offered to those whose condition is potentially reversible and who have some chance of surviving with ICU support. Since the critically ill are close to dying, the outcome of this intervention is difficult to predict. Many patients, therefore, die in the ICU. A prime requirement for admission to an Intensive Care Unit is that the underlying condition can be overcome. Treatment is meant to win time in which the acute affliction can be resolved. ICU care is generally the most expensive, highly technical and resource intensive area of medical care. In the U.S. amounting to billions each year and approximately 13% of the annual medical costs. It is money well spent because on the other side of the equation are the thousands of lives saved each year.



The information in this article is not meant to be medical advice.�Treatment for a medical condition should come at the recommendation of your personal physician.

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