Admission and discharge of critically ill patients

Current Opinion in Critical Care
Maurizia CapuzzoRaffaele Alvisi

Abstract

The intensive care unit (ICU) provides continuous surveillance and specialized care to acutely ill patients. The decisions on patient admission and discharge should be based on common clinical criteria in order to guarantee equity. The survival benefit of early admission to intensive care has been demonstrated recently. Sometimes, the number of potential patients may exceed the available beds making triage of the patients necessary. The prioritization model based on the benefit that the patient can have from the admission is the most used. In the case of the outbreak peak of pandemic A H1N1 flu, a triage plan using Sequential Organ Failure Assessment score combined with inclusion and exclusion criteria to complement clinical judgment has been recommended. Nevertheless, studies have shown that this triage could lead to withdrawal of life support in patients who survive. Triage implies refusal of some patients, and refusal rates vary greatly even across the same country. Policies for discharge from intensive care show wide variability influenced by the availability of step-down facilities. The decisions to admit and discharge patients depend on patient, structure and physician-related variables. Early ICU admission of the critica...Continue Reading

Associated Clinical Trials

References

Nov 14, 1997·American Journal of Respiratory and Critical Care Medicine
Nov 7, 1999·Intensive Care Medicine·L SmithS V Baudouin
May 3, 2000·Lancet·C Goldfrad, K Rowan
Dec 12, 2001·Anaesthesia·M GarfieldK Gunning
Feb 21, 2003·Intensive Care Medicine·Philipp G H MetnitzJean-Roger Le Gall
Aug 19, 2003·Intensive Care Medicine·Gaetano IapichinoDinis Reis Miranda
Apr 9, 2005·Critical Care Medicine·Maité Garrouste-OrgeasUNKNOWN French ADMISSIONREA Study Group
Oct 27, 2005·Intensive Care Medicine·Claudia-Paula HeideggerUNKNOWN Swiss ICU Network
Nov 23, 2006·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Michael D ChristianFrederick M Burkle
Dec 15, 2006·Critical Care Medicine·Elisheva SimchenInbal Weiss-Salz
Nov 21, 2007·Anaesthesia and Intensive Care·D V PilcherG Hart
Apr 18, 2008·Revista Española De Enfermedades Digestivas : Organo Oficial De La Sociedad Española De Patología Digestiva·A Benítez RoldánJ M Herrerías Gutiérrez
Dec 4, 2008·Critical Care Medicine·Jack ChenUNKNOWN ANZICS Clinical Trials Group
Dec 31, 2008·Critical Care Medicine·M EscherJean-Claude Chevrolet
Feb 28, 2009·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Jesse M PinesJudd E Hollander
Mar 28, 2009·Critical Care Medicine·Theodore J IwashynaJeremy M Kahn
Sep 22, 2009·Transplantation Proceedings·K NajafizadehM Moghani-Lankarani
Jan 23, 2010·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Ryan ZarychanskiFrank Plummer
Feb 6, 2010·Intensive Care Medicine·Charles L SprungUNKNOWN European Society of Intensive Care Medicine Task Force for Intensive Care Unit Triage during an Influenza Epidemic or Mass D
Feb 17, 2010·Medicina intensiva·L Santana CabreraR Lorenzo Torrent
Mar 12, 2010·Intensive Care Medicine·Rafael FernandezUNKNOWN Sabadell Score Study Group

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Citations

Feb 22, 2012·American Journal of Respiratory and Critical Care Medicine·René RobertUNKNOWN Association des Réanimateurs du Centre Ouest Group
Apr 30, 2013·International Archives of Medicine·Shahla Siddiqui
Jan 25, 2012·Clinical Medicine : Journal of the Royal College of Physicians of London·J N Fullerton, G D Perkins
Mar 8, 2016·Journal of Critical Care·Detajin JunhasavasdikulSumalee Kiatboonsri
Jan 14, 2016·Annals of Intensive Care·S Sophie GülcherE Christiaan Boerma
Mar 23, 2011·Medicina intensiva·M Colmenero
Apr 13, 2013·Nursing in Critical Care·Heljä Lundgrén-LaineSanna Salanterä
Mar 13, 2015·Health Care Management Science·Fermín MallorJulio Barado
Feb 17, 2015·Yonsei Medical Journal·Yong Suk JoYoung-Jae Cho
Apr 2, 2020·Acta Anaesthesiologica Scandinavica·Jonas ÖsterlindTomi Myrberg
Dec 5, 2019·Revista da Associação Médica Brasileira·Glaucia GalvãoCintia Grion
May 5, 2018·Health Care Management Science·Josephine VarneyMark Mackay
Jan 12, 2021·Medicina clínica·Patricia Escudero-AchaUNKNOWN Grupo de Trabajo ADENI

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