High-dependency unit

A high-dependency unit is an area in a hospital, usually located close to the intensive care unit, where patients can be cared for more extensively than on a normal ward, but not to the point of intensive care. It is appropriate for patients who have had major surgery and for those with single-organ failure. Many of these units were set up in the 1990s when hospitals found that a proportion of patients was requiring a level of care that could not be delivered in a normal ward setting.^[1] This is thought to be associated with a reduction in mortality.^[1] Patients may be admitted to an HDU bed because they are at risk of requiring intensive care admission, or as a step-down between intensive care and ward-based care.^[1]

In 2000 the UK Department of Health issued the Comprehensive Critical Care report, which set out the number of high dependency ("level 2") beds a hospital should have to deliver care appropriately. By this time, two thirds of UK hospitals had beds identified as "high dependency".^[2] The report defines level 2 care as "more detailed observations or intervention including support for a single failing organ system or postoperative care and those 'stepping down' from higher levels of care".^[2]

If positive airway pressure ventilation is used to treat respiratory failure, this may be administered in a high dependency unit or equivalent area.^[1]^[3]

References

^ ^a ^b ^c ^d Griffiths MJ, Evans TW (January 2002). "The pulmonary physician in critical care: towards comprehensive critical care?". Thorax. 57 (1): 77–8. doi:10.1136/thorax.57.1.77. PMC 1746189. PMID 11809995.
^ ^a ^b Day V, Adam S, Asbridge J, et al. (2000). Comprehensive critical care: review of adult critical care services (PDF). London: Department of Health. Archived from the original (PDF) on 2012-10-14. Retrieved 2012-09-14.
^ Nava S, Hill N (July 2009). "Non-invasive ventilation in acute respiratory failure". Lancet. 374 (9685): 250–9. doi:10.1016/S0140-6736(09)60496-7. PMC 7138083. PMID 19616722.

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