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Intensive Care Medicine

, Volume 43, Issue 9, pp 1319–1328 | Cite as

The status of intensive care medicine research and a future agenda for very old patients in the ICU

  • H. Flaatten
  • D. W. de Lange
  • A. Artigas
  • D. Bin
  • R. Moreno
  • S. Christensen
  • G. M. Joynt
  • Sean M. Bagshaw
  • C. L. Sprung
  • D. Benoit
  • M. Soares
  • B. Guidet
Review

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.

Keywords

Octogenarians Elderly ICU Mortality Frailty Severity of illness 

Notes

Compliance with ethical standards

Conflicts of interest

All authors declared no conflict of interest regarding the preparation of this manuscript.

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Copyright information

© Springer-Verlag Berlin Heidelberg and ESICM 2017

Authors and Affiliations

  • H. Flaatten
    • 1
    • 2
  • D. W. de Lange
    • 3
  • A. Artigas
    • 4
  • D. Bin
    • 5
  • R. Moreno
    • 6
  • S. Christensen
    • 7
  • G. M. Joynt
    • 8
  • Sean M. Bagshaw
    • 9
  • C. L. Sprung
    • 10
  • D. Benoit
    • 11
  • M. Soares
    • 12
  • B. Guidet
    • 13
    • 14
    • 15
  1. 1.Department of Clinical Medicine, ICU, Haukeland University HospitalUniversity of BergenBergenNorway
  2. 2.Department of Anaesthesia and Intensive CareHaukeland University HospitalBergenNorway
  3. 3.Department of Intensive Care MedicineUniversity Medical CenterUtrechtThe Netherlands
  4. 4.Department of Intensive Care Medicine, CIBER Enfermedades RespiratoriasCorporacion Sanitaria Universitaria Parc Tauli, Autonomous University of BarcelonaSabadellSpain
  5. 5.Medical ICUPeking Union Medical College HospitalBeijingChina
  6. 6.Unidade de Cuidados Intensivos Neurocríticos, Hospital de São JoséCentro Hospitalar de Lisboa CentralLisbonPortugal
  7. 7.Department of Anaesthesia and Intensive Care MedicineAarhus University HospitalAarhusDenmark
  8. 8.Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong and School of Medicine, Royal Brisbane Clinical SchoolThe University of QueenslandQueenslandAustralia
  9. 9.Department of Critical Care Medicine, Faculty of Medicine and DentistryUniversity of AlbertaEdmontonCanada
  10. 10.Department of Anesthesiology and Critical Care MedicineHadassah Hebrew University Medical CenterJerusalemIsrael
  11. 11.Department of Intensive CareGhent University HospitalGhentBelgium
  12. 12.Department of Critical CareD’Or Institute for Research and EducationRio De JaneiroBrazil
  13. 13.Assistance Publique, Hôpitaux de Paris, Hôpital Saint-AntoineService de Réanimation MédicaleParisFrance
  14. 14.Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136Institut Pierre Louis d’Epidémiologie et de Santé PubliqueParisFrance
  15. 15.INSERM, UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé PubliqueParisFrance

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