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Changing ICU to improve life afterward

The Wall Street Journal, February 15, 2011
Hospitals are changing how they care for their sickest patients. Intensive-care units have long kept critically ill patients immobilized, heavily sedated and on a breathing machine. The aim is to keep them free of pain, anxiety and agitation as they heal and undergo invasive procedures and monitoring. But there is growing evidence that such care can increase patients' risk for other problems after they leave the hospital and in years to come. Studies show that prolonged heavy sedation, for example, can trigger or exacerbate delirium, a temporary state of acute brain injury that has been linked to higher rates of death and dementia. Patients immobilized in the ICU quickly lose muscle and bone strength and become frail, which can significantly slow the pace and degree of recovery. A year after being discharged, as many as half of ICU patients are unable to return to work.

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