ABSTRACT
Chronic critical illness (CCI) denes an increasingly recognized unique subset of critically ill patients. While surviving the acute phase of severe illness, these patients are dependent on prolonged mechanical ventilation (PMV), articial nutrition, and a host of multi-organ support for an extended period of time. The CCI syndrome (CCIS) describes a characteristic metabolic phenotype due to chronic inammation, irrespective of the inciting acute illness (e.g., trauma, sepsis, or surgery). By consensus, CCI commences at the time of tracheotomy, typically performed after 10-14 days of mechanical ventilation, reecting the view that the patient will neither die nor be weaned from the ventilator in the near future. While the ultimate goal is liberation from mechanical ventilation, attention to nutritional and metabolic parameters is now understood to play an integral role in the recovery process of CCI, as previously outlined by our group [1].
