Could Multicenter Trials Optimize the Cost of Prolonged Mechanical Ventilation?
Only a small minority of patients admitted to intensive care units (ICUs) go on to require prolonged mechanical ventilation (PMV) and hence become the population we refer to as “chronically critically ill.” Among our patient populations, these individuals require the longest ICU and hospital stays and the greatest share of our time and resources. In terms of US healthcare, they account for a disproportionate amount of bed and resource utilization on a per-patient basis. But despite the millions of ICU dollars spent, daily management options for these patients have not been rigorously studied to determine how to optimize care or reduce costs. The chronically critically ill are an intimidating population to study because of their heterogeneity. Heterogeneity within a study population creates study design challenges to account for patient-to-patient differences. PMV patients have a multitude of heterogeneities that must be accounted for in study design. Such patients vary in terms of thei
