Long-term outcomes after critical illness.

Critical illness is a severe and generalized monophasic event, and it is likely that there will be evidence of compromised reserve in all end organs if one looks hard enough for it. The crucial issues are to understand which end organs are the most vulnerable to this insult, in which organ systems the incremental disability is of the most functional consequence, and how to design an effective intervention to ameliorate the dysfunction. The long-term morbidity in survivors of critical illness is likely multifactorial. Studies of survivors of acute respiratory distress syndrome (ARDS) have shown that there are both long-term physical and neuropsychological consequences of severe illness. We need to gain a better understanding of the specific determinants of patients' inability to resume their prior work/lifestyle so that an appropriate multidisciplinary intervention can be designed and tested.