What Outcome Should I Anticipate?

The ICU can be a very intimidating or terribly frightening place. Because ICUs treat critically ill or injured patients, there are common questions and concerns of patients, their families and friends. "What is going to happen to me?" "Will I live?" "Will I be able to go home?"

Keep a few things in mind. Most people who are admitted to an ICU (80-95% depending on the type of ICU) recover and return home. However, not all of those who return home are able to maintain a normal, active lifestyle.

Also, the ICU doctors and nurses are well educated and often have much experience in providing ICU care.

No one can predict outcomes with 100% accuracy. The doctor responsible for the patient's care is the best source of a knowledgeable opinion. The doctor's opinion, including some explanation of the information on which the opinion is based, should be shared with you whenever you ask. The doctor's response should include, as appropriate, chances of survival, how long an ICU stay to expect, impact on normal activities of the patient, and answers to any specific questions you may have, including cost. It is an important part of the doctor's job to answer your questions.

Between conversations with the doctor(s), ask the ICU nurses any questions that you may not have thought to ask the doctor or if you need clarification of a doctor's response. Never think the doctors or nurses are too busy for you.

Also, some doctors use scientifically based computer software, such as the MPM or APACHE outcome prediction models, to assist in estimating survival. You can ask the doctor if one of these prediction models, based on a scoring system, is in use and whether it can be shared with and explained to you.

There are also some indicators that you can use to help determine the severity of the patient's condition for yourself. While the doctor remains the best possible source of information, use of these indicators will help you put all the other information in better perspective.

Optimistic Indicators:

  1. Only one organ failing (e.g., being on a breathing machine [mechanical ventilator], but the heart, kidneys and brain are functioning).
  2. Coming off a breathing machine in two or fewer days.
  3. Surviving a cardiac arrest and waking up within 24 hours.
  4. Blood pressure and other vital signs stable and not supported by medications.
Worrisome Indicators:
  1. Two or more organs failing (e.g., being on a breathing machine [mechanical ventilator] and needing dialysis.
  2. Staying on a breathing machine for more than three days.
  3. Surviving a cardiac arrest but not waking up in 24 hours.
  4. Blood pressure and/or other vital signs supported by medications for more than 24 hours.