INTENSIVE-CARE SERVICES - A CRISIS OF INCREASING EXPRESSED DEMAND

Critical care services appear to face increasing demand. To attempt to identify factors which may predispose to such increases in demand, th e patients and their treatment were reviewed. The patients' ages, refe rring specialty and their risk of hospital mortality were recorded on admission. The durations of respiratory and renal support (if required ) were recorded. Pulmonary artery catheter insertion and the number of vasoactive drugs infused were also noted. During the study, the capac ity of the intensive care unit was initially increased by one bed (fro m six to seven) and later by a six-bedded high-dependency unit. This c apacity increase was not matched by a proportionate decrease in occupa ncy. The patients' mean ages increased by 1 year per year. The number of patients referred from general surgery consistently increased. The proportion of patients receiving vasoactive drugs and pulmonary artery catheters declined as did the duration of respiratory and renal suppo rt.