Challenge in modern intensive care : chronic critical illness - pathophysiology and therapeutic options
The recent developments in intensive care have resulted in improved survival rates of patients treated with acute organ deficiency. As a consequence, the rate of those who survive the acute phase and subsequently require protracted organ support due to persisting organ dysfunction has been growing. Several survivors display chronic health status deterioration leading to prolonged rehabilitation or nursing, and repeated hospitalizations. The condition developed following the survival of the acute phase and requiring long-lasting intensive care is frequently termed as chronic critical illness (CCI). Several definitions exist, most of these are based on the number of ventilator days, or days of stay at the intensive care unit. Nevertheless, in spite of the initially heterogenous etiology of the acute illness, the complications associated with CCI, as well as the pathophysiological processes underlying these, are relatively uniform. This causes CCI to be a unique clinical syndrome characterized by the development of secondary infections, myopathy, central and peripheral neuropathy, and typical alterations of the hormonal and immune system functions. The outcome is heavily influenced by the frailty and comorbidities of the patient, in addition to the severity of the acute illness. The treatment of CCI patients presents a complicated task requiring multidisciplinary view and individualized therapeutic measures. Since the aging of the population and the continuously improving success rates in overcoming acute conditions also facilitate the development of CCI, the systematic overview of the underlying pathophysiological processes is pivotal for the optimization of the medical, nursing, social and economical burden presented by this syndrome. Orv Hetil. 2023; 164(18): 702-712.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:164 |
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| Enthalten in: |
Orvosi hetilap - 164(2023), 18 vom: 07. Mai, Seite 702-712 |
| Sprache: |
Ungarisch |
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| Weiterer Titel: |
A modern intenzív terápia kihívása: az elhúzódó kritikus állapot kórélettani háttere és terápiás lehetőségei |
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| Beteiligte Personen: |
Kópházi, Luca Krisztina [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 09.05.2023 Date Revised 09.05.2023 published: Electronic-Print Citation Status MEDLINE |
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| doi: |
10.1556/650.2023.32745 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 246 | 3 | 3 | |a A modern intenzív terápia kihívása: az elhúzódó kritikus állapot kórélettani háttere és terápiás lehetőségei |
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| 520 | |a The recent developments in intensive care have resulted in improved survival rates of patients treated with acute organ deficiency. As a consequence, the rate of those who survive the acute phase and subsequently require protracted organ support due to persisting organ dysfunction has been growing. Several survivors display chronic health status deterioration leading to prolonged rehabilitation or nursing, and repeated hospitalizations. The condition developed following the survival of the acute phase and requiring long-lasting intensive care is frequently termed as chronic critical illness (CCI). Several definitions exist, most of these are based on the number of ventilator days, or days of stay at the intensive care unit. Nevertheless, in spite of the initially heterogenous etiology of the acute illness, the complications associated with CCI, as well as the pathophysiological processes underlying these, are relatively uniform. This causes CCI to be a unique clinical syndrome characterized by the development of secondary infections, myopathy, central and peripheral neuropathy, and typical alterations of the hormonal and immune system functions. The outcome is heavily influenced by the frailty and comorbidities of the patient, in addition to the severity of the acute illness. The treatment of CCI patients presents a complicated task requiring multidisciplinary view and individualized therapeutic measures. Since the aging of the population and the continuously improving success rates in overcoming acute conditions also facilitate the development of CCI, the systematic overview of the underlying pathophysiological processes is pivotal for the optimization of the medical, nursing, social and economical burden presented by this syndrome. Orv Hetil. 2023; 164(18): 702-712 | ||
| 650 | 4 | |a English Abstract | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a CCI | |
| 650 | 4 | |a chronic critical illness | |
| 650 | 4 | |a elhúzódó kritikus állapot | |
| 650 | 4 | |a immunsuppression catabolism syndrome | |
| 650 | 4 | |a immunszupprimált katabolikus szindróma | |
| 650 | 4 | |a intensive care | |
| 650 | 4 | |a intenzív terápia | |
| 650 | 4 | |a organ dysfunction | |
| 650 | 4 | |a persistant inflammation | |
| 650 | 4 | |a perzisztáló gyulladásos | |
| 650 | 4 | |a szervi diszfunkció | |
| 700 | 1 | |a Kárpáthi, István Keve |e verfasserin |4 aut | |
| 700 | 1 | |a Kesztyűs, Viktor |e verfasserin |4 aut | |
| 700 | 1 | |a Holndonner-Kirst, Enikő |e verfasserin |4 aut | |
| 700 | 1 | |a Gulyás, Eszter |e verfasserin |4 aut | |
| 700 | 1 | |a Karvaly, Gellért Balázs |e verfasserin |4 aut | |
| 700 | 1 | |a Gál, János |e verfasserin |4 aut | |
| 700 | 1 | |a Hermann, Csaba Gyula |e verfasserin |4 aut | |
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