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Treatment and the treatment process

What intensive care is and why patients go there

The words “intensive care” can sound frightening. In reality it is the part of the hospital with the most monitoring and the most care. This topic explains calmly and simply what an intensive care unit (ICU) is, why people with leukemia may be moved there, what a day there is like, and what usually happens afterwards.

Last updated: ~6 min read
On a dark navy background, an empty ICU bay in soft light: a bed with a calmly glowing monitor and infusion pumps beside it, no people.
Figure 1.Concept: intensive care is the place of closest monitoring and care, in calm light.

01Short answer

Intensive care is a unit where people who are seriously ill, or at risk of getting worse, are watched closely around the clock and where body functions — breathing, heart, blood pressure, kidneys — are supported with machines and medicines. Usually one nurse looks after one or two patients. In leukemia, the most common reasons for going to intensive care are a serious infection (such as sepsis), breathing problems, bleeding, kidney problems, or close monitoring after certain treatments (such as a transplant or CAR-T). Sometimes the move is made early, for a short time, as a precaution. The aim is to give the body time and support to get through a difficult period. The hematology team keeps working alongside the intensive care doctors. When things improve, the patient moves back to a regular ward.

02Simple explanation

Think of intensive care as “stepped-up care”. On a regular ward one nurse looks after several patients; in intensive care a team is always close by, and monitors follow every breath and every heartbeat.

There, the team temporarily supports tired body functions so treatment can work: oxygen helps breathing, medicines help blood pressure, and sometimes machines help the kidneys. Meanwhile the main cause, such as an infection, is treated.

During leukemia treatment, immunity and blood counts can fall very low. An infection that a healthy person would shake off can sometimes become serious quickly. In that situation, moving to intensive care in good time is a sensible and caring decision.

Sometimes the move is planned — for example after major surgery, or in the first days of certain treatments when close monitoring is needed. This reflects caution, not a turn for the worse.

Intensive care is a stage you pass through. Many people return to a regular ward after a few days; for some the stay is longer. Either way, a plan for recovery follows.

03Scientific explanation

When is it needed? According to the NHS, intensive care is needed when one or more organs are not working well — for example, when someone cannot breathe well enough on their own — and after serious infections (sepsis, severe pneumonia) or major surgery. Usually there is one nurse for every one or two patients.

Leukemia and intensive care: in people with blood cancers, the most common reasons for admission are breathing failure and sepsis. A large prospective study from France and Belgium (Journal of Clinical Oncology, 2013) showed that outcomes for these patients have improved markedly compared with earlier decades, and that outcome depends more on how severely organs are affected than on the diagnosis itself.

Why acting early matters: a fever during neutropenia is treated as an emergency (NCI). Recognizing infection early and starting antibiotics quickly lowers the chance that it becomes severe. That is why teams ask intensive care doctors to review a patient as soon as they see signs of deterioration.

Care together with the family: the Society of Critical Care Medicine guidelines (2017) support family presence in the ICU, open communication and regular family meetings. After intensive care, some people have lasting weakness or problems with sleep, memory and emotions, so a separate recovery plan matters.

04What happens in the body?

What does an ICU look like?

Usually bright, calm bays or rooms where you can hear the machines. Each bed has a monitor, infusion pumps and an oxygen supply. Visiting rules are often special, and you will be asked to clean your hands on the way in. The first time, everything can feel unfamiliar — that is completely normal.

Common reasons in leukemia

Serious infection and sepsis (especially when neutrophils are low), pneumonia and breathing failure, serious bleeding, kidney problems, metabolic problems such as tumor lysis syndrome, and the need for close monitoring after a transplant or CAR-T. You can ask the team about the reason and the plan.

On a dark navy background, translucent lungs, heart and kidneys gently supported by soft golden beams of light.
Figure 2.In intensive care, tired organs are supported for a while as the cause is treated.

Who works there?

Intensive care doctors (intensivists, often anesthetists by background), ICU nurses, physiotherapists, dietitians, and sometimes a psychologist and a social worker. The hematologist keeps visiting and stays involved in treatment decisions. There is usually a named person who keeps in touch with the family.

What is a day like?

Regular checks, blood tests, medicines, changes of position, early movement and breathing exercises when possible. Some patients are drowsy or receive calming medicines for comfort. Monitoring continues through the night, so sleep is often broken.

On a dark navy background, a glowing path leading from an ICU bed to an open door with warm light beyond it.
Figure 3.Intensive care is a stage: once stable, the path leads to a regular ward and recovery.

After intensive care

Once things are stable, the patient moves to a regular ward and recovery continues. Sometimes there is a step-down unit (high-dependency unit) in between. Muscle weakness, tiredness, and problems with sleep and memory can last for a while — a separate topic covers this in detail.

What you can do

Know the warning signs and report them early; choose one person to keep in touch with the team; keep key information written down and ready (medicines, allergies, past treatment, your wishes); note your questions. Talking about your wishes with family and your doctor in advance makes decisions easier in a hard moment.

05The intensive care journey in four steps

Monitoring, support, treating the cause, and recovery.

Close monitoring — Monitors watch around the clock.1Close monitoringMonitors watch around the clock.
Organ support — Oxygen, medicines, machines if needed.2Organ supportOxygen, medicines, machines if needed.
Treating the cause — For example, antibiotics for infection.3Treating the causeFor example, antibiotics for infection.
Back to the ward — Once stable, recovery continues.4Back to the wardOnce stable, recovery continues.
Time for the bodySupport helps it through a hard period.
One teamIntensivists and hematologists together.
A recovery planCare continues after intensive care.

06Typical reasons for intensive care in leukemia (simplified)

SituationWhat is happeningWhat the ICU does
Sepsis (serious infection)Infection affects the whole body; blood pressure may dropAntibiotics, fluids, medicines to support blood pressure
Breathing failureThe lungs cannot supply enough oxygenOxygen, mask breathing support, a ventilator if needed
Serious bleedingVery few platelets or a clotting problemTransfusions, treating the cause
Kidney and metabolic problemsKidneys weaken, salts get out of balanceFluids, medicines, dialysis if needed
Monitoring after special treatmentsFor example, reactions after CAR-T or a transplantClose monitoring and early treatment

* The table is general information. Only your treating team can explain the specific reason and plan.

07Key terms

Intensive care unit (ICU)
A unit where seriously ill patients are watched closely and organs are supported.
Intensivist
A doctor who specializes in intensive care.
Sepsis
An overwhelming body reaction to infection that can affect organs.
Neutropenia
A low level of neutrophils, the cells that fight infection.
Monitor
A device that shows heart rate, blood pressure and oxygen on a screen.
Ventilator
A machine that helps with breathing or breathes for the person.
Sedation
Medicines that cause drowsiness for comfort.
High-dependency unit
A step-down unit between intensive care and a regular ward.

08Key points

  • Intensive care is the place of closest monitoring and care.
  • Being moved there does not mean there is no hope.
  • In leukemia, the main reasons are infection and breathing problems.
  • Sometimes the move is a precaution.
  • The hematology team stays involved.
  • You can ask what every machine is for.
  • Recovery after intensive care takes time.
  • Call straight away if warning signs appear.

09Frequently asked questions

Does going to intensive care mean things are hopeless?

No. Intensive care gives the body stronger support to get through a hard period. Many people return to a regular ward. The doctors can give the most accurate picture of a specific situation.

How long do people stay in intensive care?

It depends on the cause and on how the body responds: some stay a day or two, others for weeks. It helps to ask the doctors about the goals for each day and the signs of progress.

Is leukemia treatment stopped in intensive care?

This is decided case by case. Sometimes treatment continues; sometimes the complication is dealt with first. The hematologist and the intensivist decide together.

Can my family visit me?

Most ICUs allow visits, but rules differ: times, number of visitors, hand hygiene. People with signs of illness are asked not to come. Check the rules with the unit.

Will I remember nothing?

Calming medicines and serious illness can affect memory. Some people remember little; others have strange, vivid dreams. This can pass; a diary kept by family can help later.

What can I prepare in advance?

A list of your medicines, allergies and conditions, a trusted contact person, and your wishes about treatment. Talking this through with family and your doctor at a calm time makes decisions easier later.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. Does going to intensive care mean things are hopeless?

  2. How long do people stay in intensive care?

  3. Is leukemia treatment stopped in intensive care?

  4. Can my family visit me?

  5. Will I remember nothing?

  6. What can I prepare in advance?

My questions

12Sources

  1. NHS. Intensive care
  2. Intensive Care Society. What is intensive care?
  3. ICUsteps. Guide to intensive care: introduction
  4. ICUsteps. Guide to intensive care: your time in the ICU
  5. MedlinePlus (U.S. National Library of Medicine). Critical Care
  6. National Cancer Institute (NCI). Infection and Neutropenia during Cancer Treatment
  7. NHS. Sepsis
  8. Society of Critical Care Medicine (SCCM). Patient and Family Resources
  9. Journal of Clinical Oncology, 2013. Outcomes of critically ill patients with hematologic malignancies: prospective multicenter data from France and Belgium
  10. Critical Care Medicine, 2017. Guidelines for Family-Centered Care in the Neonatal, Pediatric, and Adult ICU
  11. Critical Care Medicine, 2012. Improving long-term outcomes after discharge from intensive care unit: report from a stakeholders’ conference
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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