Brain Dysfunction

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Abstract
Increasing use of intensive care unit (ICU) resources by an aging population has given rise to a new and devastating medical condition: chronic critical illness.1 Although prolonged dependence on mechanical ventilation is its hallmark, chronic critical illness is not simply an extended period of acute critical illness but a discrete syndrome encompassing distinctive derangements of metabolism, organ physiologic traits, and endocrine and immunologic function.1 This syndrome has been defined for administrative, research, and clinical purposes by the placement of tracheotomy for failure to wean in the ICU.2