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Type of ICU Influences Lung Injury Survival

WEDNESDAY Oct. 3, 2007 -- Acute lung injury patients were about one-third less likely to die if they were treated in a "closed" intensive care unit that required board-certified critical care doctors to oversee patient care, says a U.S. study.

Patients with acute lung injury -- an inflammatory disorder of the lung often seen in patients with sepsis or pneumonia -- have a high death rate. The risk of death is greatest in older patients and in those with other health problems.

The study included 1,075 patients cared for in 22 ICUs at 16 Seattle-area hospitals.

Two-thirds of the patients in this study were treated at "closed" ICUs, and the other third were treated at "open" ICUs that allow any attending physician to oversee admission and case management.

Patients treated in closed ICUs had a 35 percent death rate while those in open ICUs had a 45 percent death rate, according to the study, which is published in the American Journal of Respiratory and Critical Care Medicine.

"These findings add to the evidence of the important role of intensivist staffing in caring for critically ill patients and support the recommendations to implement closed-model ICUs in the United States," wrote study leader Dr. Miriam Treggiari, of the Harborview Medical Center at the University of Washington.

"Further studies will need to investigate if the beneficial effects of closed ICU derive from higher degree of staffing that could facilitate earlier recognition of critical/deteriorating conditions or greater expertise in the specific management aspects of critical care patients," she said.

About 25 percent of ICUs in the United States follow the closed model, according to the American College of Chest Physicians.

More information

The U.S. National Heart Lung and Blood Institute has more about acute lung injury.

Posted: October 2007


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