WhatsAppContinuous Monitoring and Support Therapy for Critically Ill Patients
The General Intensive Care Unit (ICU) is an advanced care unit in which the patient's vital functions are monitored without interruption and multidisciplinary treatment is delivered, either in life-threatening acute conditions or after major surgery. Patients do not apply to this unit directly by appointment; admission takes place only through referral to intensive care of patients who arrive at the emergency department with a life-threatening condition, who require postoperative follow-up after surgery, or whose general condition deteriorates while they are staying on a ward. The Academic Hospital General Intensive Care Unit provides care under the supervision of an intensivist 24 hours a day, equipped with advanced monitoring systems and life support technologies.
Contents
What Is the General Intensive Care Unit?
The General Intensive Care Unit is a specialised clinic in which patients requiring continuous monitoring, mechanical ventilation, intensive drug therapy and dedicated nursing care are managed in order to support the function of one or more organ systems. The core function of the unit is to stabilise vital functions, slow the progression of organ damage and bring the patient to a condition suitable for transfer to a general ward. The ICU does not operate as an isolated clinic but as a critical care system integrated with the emergency department, the operating theatre and all medical and surgical departments. Under the leadership of an intensivist, a holistic treatment process is delivered with consultation from specialties such as infectious diseases, nephrology, neurology and physical medicine.
Which Patients Are Admitted to Intensive Care?
Admission to intensive care is decided according to criteria determined by the clinician assessing the patient's medical condition; the following clinical situations may require ICU admission:
| Clinical situation | Description |
|---|---|
| Conditions in which adequate oxygenation cannot be achieved despite supplemental oxygen and mechanical ventilation becomes necessary; severe pneumonia and acute respiratory distress syndrome (ARDS) are the leading causes in this group. | |
| Conditions in which severe systemic inflammation of infectious origin causes blood pressure to fall and organ function to deteriorate; early goal-directed treatment and close monitoring are required. | |
| Patients who develop simultaneous failure of more than one organ, such as the kidney, liver, lung and heart, are admitted to the ICU because each organ requires separate support therapy. | |
| Critical postoperative monitoring is provided for patients at risk of complications who have undergone extensive abdominal, thoracic or vascular surgery. | |
| Emergencies such as traffic and workplace accidents involving severe closed head trauma, multi-system injury or internal organ damage. | |
| Electrolyte and acid-base disturbances that threaten organ function, such as diabetic ketoacidosis, hyperkalaemia or hyponatraemia. | |
| Acute intoxication presenting with loss of consciousness, respiratory depression or cardiovascular instability. | |
| Patients requiring intensive neurological monitoring because of status epilepticus (prolonged seizure activity), severe acute stroke or advanced coma. |
Monitoring, Treatment and Intervention Processes
In intensive care every patient is monitored continuously through monitoring systems that operate without interruption, and any intervention required is carried out without delay.
Continuous Monitoring
Heart rhythm (ECG), invasive and non-invasive blood pressure, oxygen saturation (SpO2), respiratory rate, body temperature and urine output are monitored 24 hours a day. Instantaneous pressure measurements taken through an invasive arterial line and a central venous catheter allow the haemodynamic picture to be assessed in real time.
Mechanical Ventilation
Patients who cannot breathe adequately on their own receive mechanical ventilation, either through endotracheal intubation or through non-invasive positive pressure ventilation (a CPAP/BiPAP mask). Ventilation parameters such as tidal volume, pressure limits and oxygen concentration are continuously optimised by the intensivist according to the mechanical properties of the patient's lungs. A tracheostomy (creation of an airway through the neck) may be planned in patients who require prolonged ventilation.
Haemodialysis and Renal Replacement Therapy
Continuous renal replacement therapy (CRRT) or intermittent haemodialysis is applied in patients who develop acute kidney failure. Because CRRT is better tolerated in haemodynamically fragile patients, it is frequently preferred in intensive care practice. Transfer to a general ward is planned during periods when kidney function has stabilised.
Vasopressor Support and Drug Infusions
Vasopressors such as norepinephrine, vasopressin and dopamine (drugs that raise blood pressure), along with sedatives, analgesics and broad-spectrum antibiotics, are given continuously in precise doses through infusion pumps. The depth of sedation is assessed more than once a day; protocols are applied to avoid the muscle weakness, pneumonia and delirium that result from unnecessarily prolonged sedation.
Total Parenteral Nutrition (TPN)
Patients who cannot be fed through the digestive system are started on TPN, which meets all their energy and nutritional needs intravenously. The clinical dietitian adjusts the daily calorie calculation and the nutritional components according to the patient's metabolic status. Once bowel function returns, the patient is switched to enteral feeding (through a nasogastric or jejunostomy tube).
Infection Control
The ICU is an environment that carries a high risk of hospital-acquired infection. Evidence-based care bundles are applied in full to prevent catheter-related bloodstream infections, ventilator-associated pneumonia and urinary catheter infections.
Multidisciplinary Team and Coordination
Intensive care is a team environment in which several specialties work in a coordinated way; every decision is taken through joint assessment.
| Team member | Area of responsibility |
|---|---|
| The physician in charge of the unit; manages the daily round, immediate decision-making and treatment protocols. Available 24 hours a day in an emergency. | |
| Provides uninterrupted bedside care, drug administration, monitoring of vital signs, device management and coordination of communication within the team. | |
| Plans antibiotic therapy, interprets culture results and develops strategies against resistant organisms. | |
| Provides consultation on the management of kidney failure and renal replacement therapy. | |
| Assesses coma, seizure and acute neurological crisis presentations and interprets the EEG (recording of brain activity). | |
| Prevents the muscle loss, pressure sores and loss of function caused by prolonged bed rest through an early mobilisation programme. | |
| Personalises enteral and parenteral nutritional support according to metabolic status and prevents the complications of inadequate nutrition. | |
| Takes an active role in bronchial hygiene procedures, breathing exercises and weaning protocols. |
Information for Families
Having a relative in intensive care is a difficult period for both the patient and the family; the unit manages this process with a structured communication protocol.
- Visiting hours: Because of the risk of infection and the patient's need for rest, visits are limited to specific times and durations. The visiting schedule is shared with the family on admission; flexibility can be provided in special circumstances.
- Daily briefing: The person designated as the family spokesperson meets the responsible intensivist one to one at a set time each day and receives information about the patient's clinical condition, the treatments applied and the expected course.
- Urgent notification: The family is contacted immediately in the event of an unexpected clinical development or a critical change in condition; contact details are recorded on admission.
- Visiting rules: Hand disinfection is compulsory on entering the ICU; a gown may be required where necessary. Not touching the devices, speaking quietly and keeping to the short visiting time all support the patient's recovery.
- Participation in decision-making: If the patient is unable to make their own decisions, the legal guardian or a first-degree relative is included in important treatment decisions. Where an ethics committee is required, the hospital's ethics consultation process is initiated.
- Psychological support: Psychologist support for family members can be requested during long stays; this support is recommended particularly during the first week spent in intensive care.
Get information about the Academic Hospital General Intensive Care Unit.
Get InformationGeneral Intensive Care at Academic Hospital
The Academic Hospital General Intensive Care Unit works under one roof with the emergency department and the operating theatre, under the supervision of an intensivist 24 hours a day; every specialty the patient needs is called to the bedside. The unit works routinely with the following departments:
- Emergency: initial stabilisation of patients in a life-threatening condition and referral to intensive care
- Anesthesia and Reanimation: critical postoperative monitoring, sedation and airway management
- Infectious Diseases: planning of antibiotic therapy and management of resistant organisms
- Nephrology: management of renal replacement therapy in acute kidney failure
- Neurology: assessment of coma, seizure and acute neurological crisis presentations
- Physical Medicine and Rehabilitation: early mobilisation and prevention of muscle loss caused by bed rest
- Nutrition and Diet: personalisation of enteral and parenteral nutritional support
Frequently Asked Questions
References
The general information given on this page about intensive care admission criteria, monitoring and support therapy is supported by the reliable health sources listed below.
- Society of Critical Care Medicine, "Critical Care Statistics and Guidelines", sccm.org
- European Society of Intensive Care Medicine, "Clinical Practice Guidelines", esicm.org
- World Health Organization, "Emergency, Critical and Operative Care", who.int
- Critical Care Medicine Journal, "SCCM Official Publication", journals.lww.com
- Singer M, et al., "The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3), JAMA 2016", pubmed.ncbi.nlm.nih.gov
- NHS, "Intensive Care", nhs.uk
The information on this page is for informational purposes only; it does not replace medical examination, diagnosis or treatment. Please consult a healthcare institution regarding your complaints.
