Two articles in the latest issue of Critical Care reveal how intensive care therapy may be beneficial in the short but not in the long term. Being treated in intensive care units may help critically ill patients survive but the quality of life - if they survive - is often severely impaired. It is unclear whether this impairment is a complication of the illness or a complication of therapy.

Many intensive care doctors believe the battle has been won once a patient leaves the intensive care unit, however Gordon Rubenfeld from the University of Washington in Seattle suggests that it is important to focus intensive care treatment on improving the long-term health of those who survive. Rubenfeld shows that doctors may face a conflict in deciding on treatments that are best at saving lives and those that give the best quality of life to those patients who survive. He stresses that more research is needed to make these decisions with confidence.

An example of research into how well or badly patients fare after they have left the intensive care unit is the study by Dale Rublee and colleagues. It examines the long-term effects of treating patients with sepsis with the drug antithrombin III. Antithrombin III affects the blood's clotting mechanism and is a potential treatment for sepsis, a critical condition characterised by a combination of problems with the clotting mechanism and an inflammation throughout the body, which can lead to multiple organ failure and death.

The results of this study suggest that treatment with antithrombin III neither improves nor diminishes patients' chances of survival but it does leave patients with an improved quality of life 90 days after treatment. By focusing on the long-term effects of treatment Rublee and colleagues may have identified a treatment that will help improve the quality of patients' lives if they survive critical illness.

Quality of life was measured by looking at a range of factors such as t
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Contact: Gordon Fletcher
gordon@biomedcentral.com
44-20-732-30-323
BioMed Central
12-Aug-2002

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