The advantages of “closed” type management in intensive care units

Background

The intensive care units (ICUs) are responsible for treating the most complex and sensitive patients in the clinic, and it often is stated that the types of management in intensive care units are associated with patient's clinical outcomes. Among the types of management in ICUs, two types are more common and more important— the “open” type and “closed” type —while each type of management has its own supportive and critics. In recent years, efforts have been made to defend each type of management in ICUs based on patients' vital indicators, such as mortality rate and length of stay in the ICU. Therefore, an important question arises regarding which type of ICU management is suitable for meeting treatment goals.

Method

The literature review was obtained using information sources such as Web of Sciences, PubMed, PMC, Google Scholar and Scopus. All articles that were published until 2024 were considered, and the English original or review publications evaluating “open” and “closed” types of ICUs management were selected. Finally, an overview was provided on patient's mortality rate and length of stay in “open” and “closed” types of ICUs.

Conclusion

Most of the findings support a “closed” type of ICU with trained intensivist supervision. However, to achieve a standard “closed” type of ICU under the supervision of trained intensivists, the necessary conditions must be performed. These necessary conditions were discussed, and a model was presented.