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Predicting what might happen to the patient

Can I ask the doctor about my loved one's prognosis?

Being in the ICU can be like a roller coaster ride for patients and families. One day, things are getting better, the next day, everything may seem worse again. This can be very difficult emotionally. Families will frequently ask the team about the patient’s prognosis and whether their loved one will survive. During the first few days in the ICU there is often a lot of uncertainty about the patient’s condition. But over time, the doctors are usually able to provide more information and better guidance to family members.

What are the chances of leaving the hospital conscious and with minimal disability after my loved one received CPR (cardiopulmonary resuscitation)?

It depends on a number of different factors. For patients whose heart stops (cardiac arrest) outside a hospital about 1 in 10 will survive to be discharged from hospital, but only 1 in 20 will have good recovery.

If the patient is already in hospital it may be more complicated:

  • For those who are older and suffer from other health problems (previous stroke, on a breathing machine, kidneys not working, low blood pressure) before the heart stopped, the chances can be quite low. Less than 1 in 50 may wake up with minimal disability;
  • For someone who has been previously well and has no other health problems, the outlook may be quite good, up to 1 in 4 may go back home with minimal disability;
  • The medical team may be able to help you better understand how your loved one is doing. Certain tests may help determine if the patient is more or less likely to wake up. It is usually easier for the team to discuss this with you after at least 3 days.

What are the chances of an elderly patient leading an independent life after the ICU?

Many patients require a lot of support for daily activities, such as bathing, dressing, walking, sitting in a chair, meal preparation, and taking medications. The elderly (those older than 70), tend to need more assistance than younger patients.

The elderly have different needs, depending on how they were doing before admission to the ICU:

  • For those who had no disability before their ICU admission, 2 out of 5 will require assistance;
  • For those who already had a few disabilities before coming into the ICU almost all will require assistance.

It is really important to consider your loved one’s values and beliefs when it comes to autonomy and independence. While some people accept help willingly, there are many patients who do not like being dependent on others for their daily needs.

How does being on the breathing machine affect recovery?

When patients are on a breathing machine for a long time (more than 3 weeks), it usually means they are quite sick. So, it may take at least another 3 to 6 weeks, if not longer, to wean them from the ventilator. Some patients are never weaned from the ventilator.

  • Half of the patients using a breathing machine for a long time do not survive;
  • Those who survive are equally split between those who are independent or minimally dependent and those with severe dependence for all their daily activities;
  • These severely dependent patients usually live in a nursing home or at their home with home care assistance.
  • It is important to consider carefully if living with the assistance of a breathing machine.

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Location and contact

Critical Care Medicine

Sunnybrook Health Sciences Centre
2075 Bayview Avenue, 
D-wing, 1st floor
room D1 08
Toronto, ON M4N 3M5

Phone: 416-480-4522
Fax: 416-480-4999

For information about patients admitted to Sunnybrook's Intensive Care Units, please contact the unit through the hospital switchboard at 416-480-6100