Smacc

Persistent critical illness

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Synopsis

Jack Iwashyna discusses his research into persistent critical illness in the ICU. While much of resuscitation focuses on the dramatic early minutes to hours of critical illness, many patients stay for days or weeks in the ICU. Jack wants to know, why do patients get stuck in the ICU, and what might we do better to improve their care? Jack became an ICU doctor because he loved drama. He wanted to find the golden hour. The golden hour describes the time to intervene, to make a difference, and to save people’s lives. It is an extraordinary thing to be able to do this, and it is sometimes possible. However, sometimes, it is not. Sometimes the golden hour is not there. Jack describes his experience with patients who would come into the ICU unwell. They would be treated aggressively and begin to get better. However, they would then take a turn for the worse. He describes this as a chronic critical illness. His patients were stably critically ill, and he could not work out why. This led Jack on a sabbatical year whe