August 13, 2002 - A growing body of evidence indicates that survivors of intensive care have an impaired quality of life. Several articles appeared this week on the consequences and outcomes associated with a patient being in an intensive-care unit (ICU).

Two articles in the latest issue of Critical Care reveal how intensive care therapy may be beneficial in the short but not in the long term. Being treated in intensive care units may help critically ill patients survive but the quality of life - if they survive - is often severely impaired. It is unclear whether this impairment is a complication of the illness or a complication of therapy. Here is an overview from the Critical Care Forum. The articles are:

• "Looking beyond 28-day all-cause mortality" - commentary from Critical Care (pdf format)
  
  
  
• "Quality of life effects of antithrombin III in sepsis survivors: results from the KyberSept trial" - full text article from Critical Care

An opposite conclusion about treatment in the intensive care unit is reached by an article from the American Journal of Kidney Diseases (AJKD). Researchers report that patients with acute renal failure have good survival and quality of life after discharge and should be treated aggressively in the intensive care unit. Summary from Doctor's Guide.

"Long-term outcomes in acute renal failure patients treated with continuous renal replacement therapies" - abstract from AJKD

The September issue of Kidney International (KI) contains a study that compares the outcomes and mortality rates of end-stage renal disease (ESRD) patients in the ICU with acute renal failure (ARF) patients in the ICU. ESRD patients did better than ARF patients in the ICU. Only 11% of ARF patients required dialysis support. ARF patients requiring dialysis treatments had the worst mortality rate - 57 percent.

"Renal failure in the ICU: Comparison of the impact of acute renal failure and end-stage renal disease on ICU outcomes" - abstract from KI

[This message has been edited by Gary Peterson (edited 08-13-2002).]