Intensive care unit

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Overview

An intensive care unit (ICU), critical care unit (CCU) or intensive treatment unit (ITU, popular in the UK) is a specialised department in a hospital that provides intensive care medicine. Many hospitals also have designated intensive care areas for certain specialities of medicine, as dictated by the needs and available resources of each hospital. The naming is not rigidly standardized.

History

In response to a polio epidemic (where many patients required constant ventilation and survelliance), Bjorn Ibsen established the first intensive care unit in Copenhagen in 1953.^[1] The first application of this idea in the US was pioneered by Dr. William Mosenthal, a surgeon at the Dartmouth-Hitchcock Medical Center.^[2] In the 1960s, the importance of cardiac arrhythmias as a source of morbidity and mortality in myocardial infarctions (Heart Attacks) was recognized. This led to the routine use of cardiac monitoring in ICUs, especially in the post-MI setting.

Types

Specialized types of ICUs include:

• Neonatal intensive care unit (NICU)
• Special Care Baby unit (SCBU)
• Pediatric Intensive Care Unit (PICU)
• Psychiatric Intensive Care Unit (PICU)
• Coronary Care Unit (CCU) for heart disease
• Mobile Intensive Care Unit (MICU)
• Surgical Intensive Care Unit (SICU)
• Cardiac Surgery Intensive Care Unit (CSICU)
• Neuroscience Critical Care Unit (NCCU)
• Overnight Intensive Recovery (OIR)
• Neuro Intensive Care Unit (NICU)
• Burn Wounds Intensive Care Unit
• Trauma Intensive care Unit (TICU)
• Shock Trauma Intensive care Unit (STICU)

Equipment and systems

Common equipment in an ICU includes mechanical ventilator to assist breathing through an endotracheal tube or a tracheotomy opening; dialysis equipment for renal problems; equipment for the constant monitoring of bodily functions; a web of intravenous lines, feeding tubes, nasogastric tubes, suction pumps, drains and catheters; and a wide array of drugs to treat the main condition(s), induce sedation, reduce pain, and prevent secondary infections.

Quality of care

Medicine suggests a relation between ICU volume and quality of care for mechanically ventilated patients. ^[3] After adjustment for severity of illness, demographic variables, and characteristics of the ICUs (including staffing by intensivists), higher ICU volume was significantly associated with lower ICU and hospital mortality rates. For example, adjusted ICU mortality (for a patient at average predicted risk for ICU death) was 21.2% in hospitals with 87 to 150 mechanically ventilated patients annually, and 14.5% in hospitals with 401 to 617 mechanically ventilated patients annually.

Staff

Medical staff typically includes intensivists with training in internal medicine, surgery, or anesthesia. Many Nurse Practitioners and Physician Assistants with specialized training are also now part of the staff that provide continuity of care for patients. Staff typically includes specially trained critical care Registered Nurses, Registered Respiratory Therapists, Nutritionists, Physical Therapists, etc.

See also

• Medicine
• Surgery
• Surgeon
• Anesthesia
• Anesthesiologist
• CRNA or Certified Registered Nurse Anesthetist
• ASA score or pre-operative physical fittness
• Patient
• Physician
• Rare diseases
• Traumatology
• Health care
• Health profession
• Health care system

References

1. ↑ Intensive Care Unit. Internet Journal of Health.
2. ↑ Remembering Dr. William Mosenthal: A simple idea from a special surgeon. Dartmouth Medicine. Retrieved on 2007-04-10.
3. ↑ Kahn JM, Goss CH, Heagerty PJ, Kramer AA, O'Brien CR, Rubenfeld GD. (2006). "Hospital volume and the outcomes of mechanical ventilation.". New England Journal of Medicine 355 (1): 41-50. Retrieved on 2006-08-02.

v • d • e Health Science · Medicine · Medical specialities · Intensive care medicine / Critical care medicine and Critical care nursing
General terms	Intensive care unit (ICU) · Neonatal intensive care unit (NICU) · Pediatric intensive care unit (PICU) · Coronary care unit (CCU) · Critical illness insurance
Conditions	Organ system failure Acute renal failure · Acute respiratory distress syndrome · Acute liver failure · Cardiogenic shock · Coma · Distributive shock · Multiple organ dysfunction syndrome · Polytrauma · Respiratory failure · Sepsis · Septic shock · Shock · Systemic inflammatory response syndrome Complications Critical illness polyneuropathy / myopathy · Critical illness–related corticosteroid insufficiency · Decubitus ulcers · Fungemia · Stress hyperglycemia · Stress ulcer Iatrogenesis Methicillin-resistant Staphylococcus aureus · Oxygen toxicity · Refeeding syndrome · Ventilator-associated lung injury · Ventilator-associated pneumonia
Diagnosis	Arterial blood gas · Arterial catheter · Blood cultures · Central venous catheter · Pulmonary artery catheter · Screening cultures
Life supporting treatments	Airway management · Chest tube · Dialysis · Enteral feeding · Goal-directed therapy · Induced coma · Mechanical ventilation · Therapeutic hypothermia · Total parenteral nutrition
Drugs	Analgesics · Antibiotics · Antithrombotics · Inotropes · Intravenous fluids · Neuromuscular-blocking drugs · Recombinant activated protein C · Sedatives · Stress ulcer prevention drugs · Vasopressors
ICU scoring systems	APACHE II · Glasgow Coma Scale · PIM2 · SAPS II · SAPS III · SOFA
Organisations	Society of Critical Care Medicine · Surviving Sepsis Campaign
Related specialties	Anesthesia · Cardiology · Internal medicine · Neurology · Pediatrics · Pulmonology · Surgery · Traumatology

v • d • e WikiDoc Research Resources for Intensive care unit
Articles on Intensive care unit	Most recent articles on Intensive care unit • Most cited articles on Intensive care unit • Review articles on Intensive care unit • Articles on Intensive care unit in N Eng J Med, Lancet, BMJ
Media (Slides, Video, Images, MP3) on Intensive care unit	Powerpoint slides on Intensive care unit • Images of Intensive care unit • Photos of Intensive care unit • Podcasts & MP3s on Intensive care unit • Videos on Intensive care unit
Evidence Based Medicine Regarding Intensive care unit	Cochrane Collaboration on Intensive care unit • Bandolier on Intensive care unit • TRIP on Intensive care unit
Cost Effectiveness of Intensive care unit	Cost Effectiveness of Intensive care unit
Clinical Trials Involving Intensive care unit	Ongoing Trials on Intensive care unit at Clinical Trials.gov • Trial results on Intensive care unit • Clinical Trials on Intensive care unit at Google
Guidelines / Policies / Government Resources (FDA/CDC) Regarding Intensive care unit	US National Guidelines Clearinghouse on Intensive care unit • NICE Guidance on Intensive care unit • NHS PRODIGY Guidance • FDA on Intensive care unit • CDC on Intensive care unit
Textbook Information on Intensive care unit	Books and Textbook Information on Intensive care unit
Pharmacology Resources on Intensive care unit	Dosing of Intensive care unit • Drug interactions with Intensive care unit • Side effects of Intensive care unit • Allergic reactions to Intensive care unit • Overdose information on Intensive care unit • Carcinogenicity information on Intensive care unit • Intensive care unit in pregnancy • Pharmacokinetics of Intensive care unit •
Genetics, Pharmacogenomics, and Proteinomics of Intensive care unit	Genetics of Intensive care unit • Pharmacogenomics of Intensive care unit • Proteomics of Intensive care unit
Newstories on Intensive care unit	Intensive care unit in the news • Be alerted to news on Intensive care unit • News trends on Intensive care unit
Commentary on Intensive care unit	Blogs on Intensive care unit
Patient Resources on Intensive care unit	Patient resources on Intensive care unit • Discussion groups on Intensive care unit • Patient Handouts on Intensive care unit • Directions to Hospitals Treating Intensive care unit • Risk calculators and risk factors for Intensive care unit
Healthcare Provider Resources on Intensive care unit	Symptoms of Intensive care unit • Causes & Risk Factors for Intensive care unit • Diagnostic studies for Intensive care unit • Treatment of Intensive care unit
Continuing Medical Education (CME) Programs on Intensive care unit	CME Programs on Intensive care unit
International Resources on Intensive care unit	Intensive care unit en Espanol • Intensive care unit en Francais
Business Resources on Intensive care unit	Intensive care unit in the Marketplace • Patents on Intensive care unit
Informatics Resources on Intensive care unit	List of terms related to Intensive care unit

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