Iatrogenic Complications in Intensive Care Unit

Abstract

The primary goal of intensive care is to prevent mortality in patients with reversible critical illness. Despite efforts to provide the best care, complications may continue to occur in the critically ill patient, either because of the natural course of the disease or after a procedure or institution of a new therapy. (Hurwitz, 2009). ¬¬¬¬¬¬¬ Iatrogenic complications are defined as an unexpected adverse condition that occurs as a result of medical care and is independent of the patient's underlying disease. Iatrogenic complications in the ICU are inevitable and often lead to medical emergencies. They may affect the clinical course of patients by increasing morbidity and mortality rates.

Intensive Care Unit (ICU) patients often require urgent, high-risk diagnostic and therapeutic procedures. Invasive procedures are frequently performed in critically ill patients. It is important for the operator to be familiar with the specific complications of each procedure, as well as steps to take in order to enhance safety and reduce adverse events. (Phua and wahidi, 2009)

The care of critically ill patients is dependent on the use of complex medical equipment. Unfortunately this equipment has the potential to develop faults, to be used incorrectly or to fail. Previous reviews of critical incidents from intensive care have identified problems with equipment as being an important cause of actual or potential harm to patients. (Valentin et al, 2006)

Many patients within ICU require a prolonged stay in an intensive care unit (ICU) before they recover from their critical illness. It has been estimated that between 2% and 11% of critically ill patients require a prolonged stay in ICU, it has also been reported to be associated with increased mortality and morbidity. (Martin et al, 2005).

Medications are the most common type of therapy in ICUs and are also associated with the most frequent type of ICU adverse events. Critically ill patients are at high risk for adverse drug events for many reasons, including the complexity of their disease that creates challenges in drug dosing, their vulnerability to rapid changes in pharmacotherapy, the intensive care environment providing ample distractions and opportunity for error, the administration of complex drug regimens, the numerous high-alert medications that they receive, and the mode of drug administration. (Sandra et al, 2010)

Adverse reactions to blood component therapy may present in a wide range of guises and transfusion must always be considered in the differential diagnosis of any unexpected clinical presentation or indeed as a contributory factor to a clinical picture. (Stramer, 2007)

Improving the quantity and quality of manpower with continuous supervision and proper training together with the frequent examination and assessment of patients is recommended to minimize iatrogenic complications and to improve outcomes in the ICU and better organization of the daily workload, avoidance of invasive monitoring, wherever this is possible, could contribute to decrease iatrogenic complications. (Ismail and Shedeed, 2012)