Intensive care unit models: Do you want them to be open or closed? A critical review

• Published in: Neurology India Vol. 65; no. 1; pp. 39 - 45
• Main Authors: Chowdhury, Debashish, Duggal, Ashish
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.01.2017; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd
• Subjects: Analysis; Evidence-based medicine; Intensive care units; Quality management; India; mortality; intensive care unit; semi-closed ICU Key Messages: Neurocritical care is a highly-specialized field but there is a paucity of neurocritical care specialistsA closed ICU mode headed by an intensivist may be ideal but not cost - effective especially in a country like IndiaA semi-closed ICU with appropriate well-written protocols and a good nurse-patient ratio could be the solution to the reduction in mortality rates and the reduction in the duration of hospital stay so that the ICUs are utilized in a cost - effective manner; hospital stay; open ICU; Closed ICU
• ISSN: 0028-3886; 1998-4022
• DOI: 10.4103/0028-3886.198205

Intensive care is a specialized branch of medicine dealing with the diagnosis, management, and follow up of critically ill or critically injured patients. It requires input from other branches of medicine on various issues. A critical care specialist has expertise in managing such patients round the clock. Based on his freedom to take decisions in the intensive care unit (ICU), different types of ICUs - open, closed, or semi-closed - have been defined. There is no doubt that all critical patients should be evaluated by an intensivist. Therefore, it is argued that a closed ICU model would be the ideal model. However, this may not always be feasible and other models may be more useful in resource-limited countries. In this review, we compare the different formats of ICU functioning and their suitability in different hospitals.