%0 Journal Article
%T Surviving intensive care
%A Carl Waldmann
%J Critical Care
%D 2003
%I BioMed Central
%R 10.1186/cc2181
%X It is heartening for me to see a book on the subject edited by two eminent intensivists, one from France and the other from the USA (although originally Scottish). The book includes 25 chapters written by 48 well known authors. The editors managed to group the chapters into broad subsections. There is no cross-referencing between chapters.I liked the mention in Chapter 1 of the appropriateness of the ICU for HIV patients in the light of new treatment regimes that have radically altered long-term outcome, and in the chapter on neuropsychological consequences of intensive care the word 'skepticism' was used (page 51) referring to any multicentre trial published without long-term data which for me fully justifies the need for following up patients after they have left the intensive care environment.Trying to put a monetary value on the long-term consequences of surviving intensive care was the theme of Chapter 6 and is essential reading. It is my experience, however, that many patients do not receive appropriate rehabilitation care (unlike post-myocardial infarction patients), including the most basic physiotherapy interventions, once they are back in the community; this can further complicate the equation. The second subsection of the book concentrates on predictors/modifiers of long-term outcomes, and the main point that surfaces is the lack of data.There is no doubt that we need to improve the methods by which we capture long-term ICU survival data. This is the subject of the third subsection of the book, and the point is well made that we should look to cancer research, in which a successful multidisciplinary approach has been used for 50 years, for clues to guide us in the follow up of ICU patients. The chapter in which information provided to family members is evaluated is interesting and extremely important, but it did not necessarily fit into this book.In the last subsection of the book the need to be more proactive in modifying triage decisions to optimize tri
%U http://ccforum.com/content/7/3/265