We recently cared for a 57-year-old female admitted to the internal medicine ward at our hospital with shortness of breath, worsening dysphagia and increasing peripheral edema for 3 weeks. Past medical history was significant for polymyositis, treated previously with corticosteroids and intravenous immunoglobulin. When her symptoms worsened progressively, she was admitted to the intensive care unit of the internal medicine department (ICU-IM). After 1 week, we performed endotracheal intubation and 2 weeks later tracheostomy. In the ICU-IM, our patient suffered several episodes of ventilator-associated pneumonia and septic shock, leading to organ damage (renal, gastrointestinal and endocrine). Recovery occurred gradually in the ICU-IM over 3 months, such that she regained the ability to breathe and feed on her own. As highly qualified personnel in our small (6 bed) ICU-IM deliver expert healthcare to the most critically ill patients, plans were made per standard hospital protocol to transfer this improving patient from the ICU-IM to a general internal medicine ward and later to an intensive rehabilitation center. During the patient׳s recovery period, we provided the patient and family with projected dates and specific goals for transfer.
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Published online: February 16, 2017
Accepted: January 24, 2017
Received in revised form: January 11, 2017
Received: November 2, 2016
☆The author has no financial or other conflicts of interest to disclose.
© 2017 Southern Society for Clinical Investigation. Published by All rights reserved.