Chronically Critical Illness

Most surviving patients after severe brain injury meet the criteria for being chronically critically ill (CCI). Chronically critically ill criteria include:

• At least 2 weeks in an intensive care unit (ICU)


• Prolonged mechanical ventilation (14–28 days)


• Persistent inflammation


• Immunosuppression


• Hypermetabolism and hypercatabolism


• Increased susceptibility to infection

Chronically critically ill (CCI) patients are a distinct group within the ICU population who experience prolonged critical illness and require extended medical support. These patients often survive the acute phase of their illness but do not recover quickly enough to become independent, leading to a slow and complex recovery process.

Several factors have been described as potential initiators of critical illness, including:

• Septic, …