Aggressive reimbursement reform has been an imposing directive for care providers of ICU medicine. Timely knowledge of actual care routines obtained from a large sample of actively practicing physicians should be mandatory when developing any guidelines or practice standards. A questionnaire was therefore designed by the steering committee of the ACCP Council on Critical Care and sent to its members. The 1,294 responses were analyzed for demographics of the individual practitioner, local aspects of ICU staffing and policies, reimbursement, and a specific practice issue, nutrition. The typical respondent was aged 41 to 50 (41 percent), was a pulmonary subspecialist (68 percent), was not critical care certified (55 percent), worked 25 to 50 percent of his or her total time in the ICU (40 percent), and would continue ICU practice despite poor reimbursement (82 percent). Physicians practiced within a group (53 percent), in a 100- to 500-bed hospital (69 percent), with house staff available (60 percent), and predominantly cared for Medicare patients (55 percent). The following data may allow better judgments to be made pertaining to the implementation of care policies in the current ICU environment.

Another reason to be wary of a hospital stay- a new study shows that patients who survive intensive care units in hospitals are at high risk for developing post-traumatic stress disorder (PTSD).

PTSD is in the news most often in relation to combat veterans, but researchers from the Johns Hopkins University School of Medicine found that one in three people who survived an intensive care unit (ICU) stay for acute lung injury showed PTSD symptoms that lasted up to two years.

Post Intensive Care Syndrome (PICS) is a group of health problems that can include physical impairments, mental health issues, and cognitive difficulties following a critical illness or hospital stay. Critical diseases can consist of but are not limited to heart attacks, stroke, congestive heart failure, pneumonia, pulmonary embolism, motor vehicle accident, burns, and surgical problems. Nearly one million people are admitted to the ICU each year, with close to a third requiring ventilation. Sepsis, delirium, and acute respiratory distress syndrome increase the odds of being diagnosed with PICS.