Abstract Background Despite persistent enforcement efforts, immigration along the U.S.-Mexico border remains substantial. In the Rio Grande Valley, one of the busiest crossing regions, many individuals present for medical care after long journeys. Their presentations range from mild dehydration to severe metabolic or hemodynamic compromise requiring intensive care. Yet, this population has rarely been systematically described. We sought to characterize the clinical, social, and healthcare-utilization profiles of patients admitted to the intensive care unit (ICU) after crossing the Texas-Mexico border. Methods We conducted a retrospective case series of eight adult patients in immigration custody who required ICU admission between January 2023 and January 2025 at a tertiary-care facility in a border community. Recorded variables included demographics, comorbidities, exposure history, reason for ICU admission, acute kidney injury (AKI) status, vasopressor or mechanical ventilation use, ICU and hospital length of stay (LOS), interpreter use, discharge barriers, and disposition. Results Median age was 38.6 years; 62.5 % were male. Most patients originated from Central or South America, and 87.5 % were Spanish-speaking, requiring interpreter services. Hypertension and type 2 diabetes mellitus were each present in 37.5 %. Prolonged exertion or heat exposure was documented in 87.5 %. The primary reasons for ICU admission were septic shock (37.5 %) and ketoacidosis (25 %); dehydration was present in 87.5 %. AKI occurred in 62.5 % of cases; vasopressors were required in 37.5 %; none required mechanical ventilation. Median ICU LOS was 2.3 days and hospital LOS 5.3 days. All patients survived; 50 % were discharged to community shelters and 37.5 % to custodial facilities. Discharge barriers were common, including limited medication access (87.5 %) and restricted follow-up (75 %). Discussion This cohort was relatively young yet metabolically fragile, reflecting a shift from the “healthy traveler” profile toward individuals with chronic disease. Conditions such as type 2 diabetes mellitus, hypertension, and use of sodium-glucose cotransporter-2 inhibitors likely increased vulnerability to dehydration and ketoacidosis. The combination of chronic disease, exertional stress, and delayed access to care produced short but resource-intensive critical illness. These findings suggest that structural and social determinants, rather than illness severity alone, drive critical-care utilization in border hospitals. Conclusions Migrants in immigration custody requiring ICU admission most often presented with acute kidney injury, shock, and ketoacidosis related to exertion and dehydration. Although all survived and hospitalizations were brief, management required substantial critical-care resources and complex discharge coordination. This abstract is funded by: None
Pozo et al. (Fri,) studied this question.