The status of intensive care medicine research and a future agenda for very old patients in the ICU.
Identifieur interne : 004371 ( Ncbi/Merge ); précédent : 004370; suivant : 004372The status of intensive care medicine research and a future agenda for very old patients in the ICU.
Auteurs : H. Flaatten [Norvège] ; D W De Lange [Pays-Bas] ; A. Artigas [Espagne] ; D. Bin [République populaire de Chine] ; R. Moreno [Portugal] ; S. Christensen [Danemark] ; G M Joynt [Australie] ; Sean M. Bagshaw [Canada] ; C L Sprung [Israël] ; D. Benoit [Belgique] ; M. Soares [Brésil] ; B. Guidet [France]Source :
- Intensive care medicine [ 1432-1238 ] ; 2017.
Abstract
The "very old intensive care patients" (abbreviated to VOPs; greater than 80 years old) are probably the fastest expanding subgroup of all intensive care unit (ICU) patients. Up until recently most ICU physicians have been reluctant to admit these VOPs. The general consensus was that there was little survival to gain and the incremental life expectancy of ICU admission was considered too small. Several publications have questioned this belief, but others have confirmed the poor long-term mortality rates in VOPs. More appropriate triage (resource limitation enforced decisions), admission decisions based on shared decision-making and improved prediction models are also needed for this particular patient group. Here, an expert panel proposes a research agenda for VOPs for the coming years.
DOI: 10.1007/s00134-017-4718-z
PubMed: 28238055
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Flaatten</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Medicine, ICU, Haukeland University Hospital, University of Bergen, Bergen, Norway. Hans.Flaatten@uib.no.</nlm:affiliation><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Clinical Medicine, ICU, Haukeland University Hospital, University of Bergen, Bergen</wicri:regionArea><wicri:noRegion>Bergen</wicri:noRegion></affiliation></author><author><name sortKey="De Lange, D W" sort="De Lange, D W" uniqKey="De Lange D" first="D W" last="De Lange">D W De Lange</name><affiliation wicri:level="3"><nlm:affiliation>Department of Intensive Care Medicine, University Medical Center, Utrecht, The Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Intensive Care Medicine, University Medical Center, Utrecht</wicri:regionArea><placeName><settlement type="city">Utrecht</settlement><region nuts="2" type="province">Utrecht (province)</region></placeName></affiliation></author><author><name sortKey="Artigas, A" sort="Artigas, A" uniqKey="Artigas A" first="A" last="Artigas">A. Artigas</name><affiliation wicri:level="1"><nlm:affiliation>Department of Intensive Care Medicine, CIBER Enfermedades Respiratorias, Corporacion Sanitaria Universitaria Parc Tauli, Autonomous University of Barcelona, Sabadell, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Intensive Care Medicine, CIBER Enfermedades Respiratorias, Corporacion Sanitaria Universitaria Parc Tauli, Autonomous University of Barcelona, Sabadell</wicri:regionArea><wicri:noRegion>Sabadell</wicri:noRegion></affiliation></author><author><name sortKey="Bin, D" sort="Bin, D" uniqKey="Bin D" first="D" last="Bin">D. Bin</name><affiliation wicri:level="1"><nlm:affiliation>Medical ICU, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Medical ICU, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730</wicri:regionArea><wicri:noRegion>100730</wicri:noRegion></affiliation></author><author><name sortKey="Moreno, R" sort="Moreno, R" uniqKey="Moreno R" first="R" last="Moreno">R. Moreno</name><affiliation wicri:level="1"><nlm:affiliation>Unidade de Cuidados Intensivos Neurocríticos, Hospital de São José, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.</nlm:affiliation><country xml:lang="fr">Portugal</country><wicri:regionArea>Unidade de Cuidados Intensivos Neurocríticos, Hospital de São José, Centro Hospitalar de Lisboa Central, Lisbon</wicri:regionArea><wicri:noRegion>Lisbon</wicri:noRegion></affiliation></author><author><name sortKey="Christensen, S" sort="Christensen, S" uniqKey="Christensen S" first="S" last="Christensen">S. Christensen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Anaesthesia and Intensive Care Medicine, Aarhus University Hospital, Aarhus, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Anaesthesia and Intensive Care Medicine, Aarhus University Hospital, Aarhus</wicri:regionArea><wicri:noRegion>Aarhus</wicri:noRegion></affiliation></author><author><name sortKey="Joynt, G M" sort="Joynt, G M" uniqKey="Joynt G" first="G M" last="Joynt">G M Joynt</name><affiliation wicri:level="1"><nlm:affiliation>Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong and School of Medicine, Royal Brisbane Clinical School, The University of Queensland, Queensland, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong and School of Medicine, Royal Brisbane Clinical School, The University of Queensland, Queensland</wicri:regionArea><wicri:noRegion>Queensland</wicri:noRegion></affiliation></author><author><name sortKey="Bagshaw, Sean M" sort="Bagshaw, Sean M" uniqKey="Bagshaw S" first="Sean M" last="Bagshaw">Sean M. Bagshaw</name><affiliation wicri:level="1"><nlm:affiliation>Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton</wicri:regionArea><wicri:noRegion>Edmonton</wicri:noRegion></affiliation></author><author><name sortKey="Sprung, C L" sort="Sprung, C L" uniqKey="Sprung C" first="C L" last="Sprung">C L Sprung</name><affiliation wicri:level="1"><nlm:affiliation>Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, Jerusalem, Israel.</nlm:affiliation><country xml:lang="fr">Israël</country><wicri:regionArea>Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, Jerusalem</wicri:regionArea><wicri:noRegion>Jerusalem</wicri:noRegion></affiliation></author><author><name sortKey="Benoit, D" sort="Benoit, D" uniqKey="Benoit D" first="D" last="Benoit">D. Benoit</name><affiliation wicri:level="1"><nlm:affiliation>Department of Intensive Care, Ghent University Hospital, de pintelaan 185, 2K12IC, Ghent, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Intensive Care, Ghent University Hospital, de pintelaan 185, 2K12IC, Ghent</wicri:regionArea><wicri:noRegion>Ghent</wicri:noRegion></affiliation></author><author><name sortKey="Soares, M" sort="Soares, M" uniqKey="Soares M" first="M" last="Soares">M. Soares</name><affiliation wicri:level="1"><nlm:affiliation>Department of Critical Care, D'Or Institute for Research and Education, Rio De Janeiro, Brazil.</nlm:affiliation><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Critical Care, D'Or Institute for Research and Education, Rio De Janeiro</wicri:regionArea><wicri:noRegion>Rio De Janeiro</wicri:noRegion></affiliation></author><author><name sortKey="Guidet, B" sort="Guidet, B" uniqKey="Guidet B" first="B" last="Guidet">B. Guidet</name><affiliation wicri:level="3"><nlm:affiliation>Assistance Publique, Hôpitaux de Paris, Hôpital Saint-Antoine, Service de Réanimation Médicale, 75012, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Assistance Publique, Hôpitaux de Paris, Hôpital Saint-Antoine, Service de Réanimation Médicale, 75012, Paris</wicri:regionArea><placeName><settlement type="city">Paris</settlement><region type="région" nuts="2">Île-de-France</region></placeName></affiliation></author></analytic><series><title level="j">Intensive care medicine</title><idno type="eISSN">1432-1238</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The "very old intensive care patients" (abbreviated to VOPs; greater than 80 years old) are probably the fastest expanding subgroup of all intensive care unit (ICU) patients. Up until recently most ICU physicians have been reluctant to admit these VOPs. The general consensus was that there was little survival to gain and the incremental life expectancy of ICU admission was considered too small. Several publications have questioned this belief, but others have confirmed the poor long-term mortality rates in VOPs. More appropriate triage (resource limitation enforced decisions), admission decisions based on shared decision-making and improved prediction models are also needed for this particular patient group. Here, an expert panel proposes a research agenda for VOPs for the coming years.</div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">28238055</PMID><DateCreated><Year>2017</Year><Month>02</Month><Day>26</Day></DateCreated><DateRevised><Year>2017</Year><Month>08</Month><Day>25</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1432-1238</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2017</Year><Month>Feb</Month><Day>25</Day></PubDate></JournalIssue><Title>Intensive care medicine</Title><ISOAbbreviation>Intensive Care Med</ISOAbbreviation></Journal><ArticleTitle>The status of intensive care medicine research and a future agenda for very old patients in the ICU.</ArticleTitle><ELocationID EIdType="doi" ValidYN="Y">10.1007/s00134-017-4718-z</ELocationID><Abstract><AbstractText>The "very old intensive care patients" (abbreviated to VOPs; greater than 80 years old) are probably the fastest expanding subgroup of all intensive care unit (ICU) patients. Up until recently most ICU physicians have been reluctant to admit these VOPs. The general consensus was that there was little survival to gain and the incremental life expectancy of ICU admission was considered too small. Several publications have questioned this belief, but others have confirmed the poor long-term mortality rates in VOPs. More appropriate triage (resource limitation enforced decisions), admission decisions based on shared decision-making and improved prediction models are also needed for this particular patient group. Here, an expert panel proposes a research agenda for VOPs for the coming years.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Flaatten</LastName><ForeName>H</ForeName><Initials>H</Initials><Identifier Source="ORCID">http://orcid.org/0000-0001-9186-3482</Identifier><AffiliationInfo><Affiliation>Department of Clinical Medicine, ICU, Haukeland University Hospital, University of Bergen, Bergen, Norway. Hans.Flaatten@uib.no.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway. Hans.Flaatten@uib.no.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>de Lange</LastName><ForeName>D W</ForeName><Initials>DW</Initials><AffiliationInfo><Affiliation>Department of Intensive Care Medicine, University Medical Center, Utrecht, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Artigas</LastName><ForeName>A</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Intensive Care Medicine, CIBER Enfermedades Respiratorias, Corporacion Sanitaria Universitaria Parc Tauli, Autonomous University of Barcelona, Sabadell, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bin</LastName><ForeName>D</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Medical ICU, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Moreno</LastName><ForeName>R</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Unidade de Cuidados Intensivos Neurocríticos, Hospital de São José, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Christensen</LastName><ForeName>S</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Anaesthesia and Intensive Care Medicine, Aarhus University Hospital, Aarhus, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Joynt</LastName><ForeName>G M</ForeName><Initials>GM</Initials><AffiliationInfo><Affiliation>Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong and School of Medicine, Royal Brisbane Clinical School, The University of Queensland, Queensland, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bagshaw</LastName><ForeName>Sean M</ForeName><Initials>SM</Initials><AffiliationInfo><Affiliation>Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sprung</LastName><ForeName>C L</ForeName><Initials>CL</Initials><AffiliationInfo><Affiliation>Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, Jerusalem, Israel.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Benoit</LastName><ForeName>D</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Intensive Care, Ghent University Hospital, de pintelaan 185, 2K12IC, Ghent, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Soares</LastName><ForeName>M</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Critical Care, D'Or Institute for Research and Education, Rio De Janeiro, Brazil.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Guidet</LastName><ForeName>B</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Assistance Publique, Hôpitaux de Paris, Hôpital Saint-Antoine, Service de Réanimation Médicale, 75012, Paris, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 75013, Paris, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 75013, Paris, France.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>02</Month><Day>25</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Intensive Care Med</MedlineTA><NlmUniqueID>7704851</NlmUniqueID><ISSNLinking>0342-4642</ISSNLinking></MedlineJournalInfo><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Crit Care Med. 2010 Jan;38(1):59-64</RefSource><PMID Version="1">19633539</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Ann Intensive Care. 2015 Dec;5(1):56</RefSource><PMID Version="1">26092498</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Brain. 2012 Sep;135(Pt 9):2809-16</RefSource><PMID Version="1">22879644</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Crit Care Med. 2015 May;43(5):973-82</RefSource><PMID Version="1">25668751</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>PLoS One. 2014 Jan 15;9(1):e83795</RefSource><PMID 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Jan;40(1):132-8</RefSource><PMID Version="1">22001580</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Intensive Care Med. 2005 Oct;31(10):1345-55</RefSource><PMID Version="1">16132892</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Crit Care Med. 2015 Jan;43(1):40-7</RefSource><PMID Version="1">25251759</PMID></CommentsCorrections></CommentsCorrectionsList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Elderly</Keyword><Keyword MajorTopicYN="N">Frailty</Keyword><Keyword MajorTopicYN="N">ICU</Keyword><Keyword MajorTopicYN="N">Mortality</Keyword><Keyword MajorTopicYN="N">Octogenarians</Keyword><Keyword MajorTopicYN="N">Severity of illness</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2016</Year><Month>12</Month><Day>10</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2017</Year><Month>02</Month><Day>08</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>2</Month><Day>27</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>2</Month><Day>27</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>2</Month><Day>27</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">28238055</ArticleId><ArticleId IdType="doi">10.1007/s00134-017-4718-z</ArticleId><ArticleId IdType="pii">10.1007/s00134-017-4718-z</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Australie</li><li>Belgique</li><li>Brésil</li><li>Canada</li><li>Danemark</li><li>Espagne</li><li>France</li><li>Israël</li><li>Norvège</li><li>Pays-Bas</li><li>Portugal</li><li>République populaire de Chine</li></country><region><li>Utrecht 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Flaatten</name></noRegion></country><country name="Pays-Bas"><region name="Utrecht (province)"><name sortKey="De Lange, D W" sort="De Lange, D W" uniqKey="De Lange D" first="D W" last="De Lange">D W De Lange</name></region></country><country name="Espagne"><noRegion><name sortKey="Artigas, A" sort="Artigas, A" uniqKey="Artigas A" first="A" last="Artigas">A. Artigas</name></noRegion></country><country name="République populaire de Chine"><noRegion><name sortKey="Bin, D" sort="Bin, D" uniqKey="Bin D" first="D" last="Bin">D. Bin</name></noRegion></country><country name="Portugal"><noRegion><name sortKey="Moreno, R" sort="Moreno, R" uniqKey="Moreno R" first="R" last="Moreno">R. Moreno</name></noRegion></country><country name="Danemark"><noRegion><name sortKey="Christensen, S" sort="Christensen, S" uniqKey="Christensen S" first="S" last="Christensen">S. Christensen</name></noRegion></country><country name="Australie"><noRegion><name sortKey="Joynt, G M" sort="Joynt, G M" uniqKey="Joynt G" first="G M" last="Joynt">G M Joynt</name></noRegion></country><country name="Canada"><noRegion><name sortKey="Bagshaw, Sean M" sort="Bagshaw, Sean M" uniqKey="Bagshaw S" first="Sean M" last="Bagshaw">Sean M. Bagshaw</name></noRegion></country><country name="Israël"><noRegion><name sortKey="Sprung, C L" sort="Sprung, C L" uniqKey="Sprung C" first="C L" last="Sprung">C L Sprung</name></noRegion></country><country name="Belgique"><noRegion><name sortKey="Benoit, D" sort="Benoit, D" uniqKey="Benoit D" first="D" last="Benoit">D. Benoit</name></noRegion></country><country name="Brésil"><noRegion><name sortKey="Soares, M" sort="Soares, M" uniqKey="Soares M" first="M" last="Soares">M. Soares</name></noRegion></country><country name="France"><region name="Île-de-France"><name sortKey="Guidet, B" sort="Guidet, B" uniqKey="Guidet B" first="B" last="Guidet">B. 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