What is ICU Care?
When patients need intensive care for serious illness or organ failure, they may be cared for in the Intensive Care Unit (ICU).
Patients may be in the ICU because of:
- severe infection or bleeding
- breathing problems
- a bad accident
- major surgery
Along with strong medicines, there are several machines used in the ICU, including:
- ventilators, or breathing machines
- mechanical pumps to keep the heart beating
- intravenous catheters (small plastic tubes put into big veins) that are used to provide medications.
- plastic tubes placed into the stomach to provide medications and nutrition
Outcomes of ICU Care
Most patients will recover from a serious illness when admitted to the ICU, especially if they have had a short stay.
However, if you are in the ICU for more than 1-2 weeks, you may leave the hospital much weaker than you were before. You may also have problems thinking or concentrating. In addition, up to half of ICU survivors who have had a long stay will have significant depression, anxiety, or post-traumatic stress disorder in the months that follow illness.
Without intensive care, most seriously ill patients with organ failure will die. However, even with intensive care, some patients will die from their serious illness. On average, about 20% of ICU patients will die and 80% will survive and leave the hospital.
This survival rate can be higher or lower, depending on specific cases. For example, if you have a severe infection you will have a much lower survival rate. On the other hand, if you are in the ICU to recover from major surgery, you will have a much better survival rate. Age can also make a difference.
Overall Risks and Benefits of ICU care:
Benefits:
- If you are very ill, there is a greater chance of survival in the ICU than with other types of medical care
- If you are in the ICU on machines for only a short period of time, you will likely fully recover and get back to your baseline health
Risks:
- You may be in more pain and discomfort because of the machines used
- You may not be able to speak or interact with your loved ones
- If you are in the ICU on machines for more than one week, you might end up weak and less mentally aware
- You may only be delaying death and your death may not end up being very natural or dignified.
Is ICU Right for you?
Most people who pick ICU care have:
- fixable medical problems
- a reasonably high level of function or quality of life
- are willing to accept the burdens or risks of ICU treatment.
The negative consequences of ICU care usually happen after an ICU stay of more than 7 days. Therefore, some people are willing to undergo ICU care on the ‘short-term’ (less than a week in most instances). It’s like a ‘trial’ of ICU treatments, to see if they will get better quickly and recover back to their baseline function and quality of life.
However, if their illness turns into a prolonged ICU stay, they are unwilling to accept the risks of ICU care. In this case, patients prefer to have their goals of care change to focus on comfort measures only. In that instance, ICU treatments may be withdrawn or withheld.
Extra Resources
For more information on ICU care, check out these brief videos:
This video shows a discussion between a doctor and a patient talking about care in the ICU:
For more information on how patients from who survive ICU care can leave worse off:
