More than 3600 critically ill patients are admitted to the intensive care units of LHSC each year. Approximately 5% of these patients require prolonged mechanical ventilation (>21 days). Of those patients who require PMV, approximately 30% will die in our critical care units due to infections and complications. ). Although most patients are eventually weaned from mechanical ventilation after many weeks or months, some patients remain dependent on mechanical ventilation.
The Critical Care team has a vested interest in ensuring that these PMV patients with chronic critical illness are identified early. OUr experience has shown that early identification of these patients, ensures the most appropriate model of care is utilized to optimize weaning from the ventilator. At University Hospital the Extended Intensive Care Unit (EICU or Bay 6) is designated within the Medical Surgical Intensive Care Unit to meet the ongoing care needs of patients with uncertain hospital discharge disposition, low acuity of illness, and anticipated or actual need for PMV. The focus of care within the EICU is dependent upon patient’s and/or family’s wishes and goals of care. The goals of care include establishing routines of advancing mobility and independence through rehabilitation; ventilator weaning and symptom management; reducing monitoring requirements; and addressing end-of-life issues.
