Building an Evidence Base for Survivors of Critical Illness

On rounds in the long-term acute care hospital, I am surprised to see a familiar name on my list - a patient with respiratory failure whom I had initially admitted to our intensive care unit (ICU). In the early days of his critical illness, we had debated ventilator management and choice of antibiotic agents, with every decision dictated by a body of evidence. Now, months later, I am at his bedside once again. And this time he has a question for me. Gesturing impatiently to the tracheostomy tube in his neck, he asks, "When can this come out?" I hesitate. . . .