Cardiopulmonary intermediate intensive unit: time course of two years activity.

Intermediate intensive care may be defined as a post comprehensive programme, where monitoring, combined with necessary treatment, improves and maintains physiological functions to complete the cure of underlying diseases. The aims of this paper are: 1) to describe the caring activity that patients admitted to our 12 bed Cardiopulmonary Intermediate Intensive Unit (CPIIU) experience and, 2) to demonstrate that a noninvasive choice does not worsen mortality and the quality of care needed to improve patient outcome. From September 1st 1990 to September 30th 1992, 775 patients (135 respiratory subjects) were admitted. The majority of these patients came from Coronary Intensive Units or Medical and Surgical Intensive Care Units. Noninvasive cardiorespiratory monitoring was assessed in these patients, to obtain their clinical improvement. After this post acute observance, our patients were followed during a stabilization programme in the cardiopulmonary rehabilitation division until a day-hospital or home care programme was carried out. By implementing the CPIIU principles in our department we have reduced the number of deaths and the necessity for Intensive Care Unit admission (from 19 to 9.6\%). The estimated risk of death proposed by Apache score was higher than that recorded in our patients (estimated Apache = 25 and 6\% for respiratory and cardiac patients, respectively; actual Apache = 10.4 and 3.1\% for the same patients, respectively). Average hospitalisation days in our CPIIU was 18 +/- 9. Our CPIIU showed a mean daily cost for each patient of $370.6.