Elderly Patients and Management in Intensive Care Units (ICU): Clinical Challenges

Lucille B Brunker,1 Christina S Boncyk,1,2 Kimberly F Rengel,1,2 Christopher G Hughes1,2 1Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA; 2Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, USACorrespondence: Lucille B Brunker, Department of Anesthesiology, Vanderbilt University Medical Center, 1211 21st Avenue South, Medical Arts Building #422, Nashville, TN, 37212, USA, Tel +1 615-936-2857, Email lucille.brunker@vumc.orgAbstract: There is a growing population of older adults requiring admission to the intensive care unit (ICU). This population outpaces the ability of clinicians with geriatric training to assist in their management. Specific training and education for intensivists in the care of older patients is valuable to help understand and inform clinical care, as physiologic changes of aging affect each organ system. This review highlights some of these aging processes and discusses clinical implications in the vulnerable older population. Other considerations when caring for these older patients in the ICU include functional outcomes and morbidity, as opposed to merely a focus on mortality. An overall holistic approach incorporating physiology of aging, applying current evidence, and including the patient and their family in care should be used when caring for older adults in the ICU.Keywords: geriatric syndrome, critical illness, organ dysfunction, shock, respiratory failure