Curtis J Randall
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Harborview Medical Center, University of Washington, Seattle, Washington 98104-2499, USA.
Respir Care. 2002 Apr;47(4):496-505; discussion 505-7.
In the critical care setting, usually the most important outcome is survival. However, this is not the only important outcome of critical care. There are increasing data that the patient's quality of life and functional status can be affected long after an intensive care unit stay, and some data suggest that mechanical ventilation strategies could influence those outcomes. Critical care clinicians' decisions regarding mechanical ventilation and related treatments such as level of sedation might have more profound and far-reaching residual effects than has been previously recognized. To deliver effective, cost-effective, and patient-centered care, critical-care clinicians must consider outcomes other than survival. These outcomes include such diverse concepts as quality of life, functional status, and neuropsychological function. This review addresses theoretical and practical challenges to measuring and interpreting those other outcomes.
在重症监护环境中，通常最重要的结果是存活。然而，这并非重症监护的唯一重要结果。越来越多的数据表明，患者在重症监护病房停留后的很长一段时间里，其生活质量和功能状态可能会受到影响，并且一些数据显示机械通气策略可能会影响这些结果。重症监护临床医生在机械通气及相关治疗（如镇静水平）方面的决策，可能具有比以往认识到的更为深远和持久的影响。为了提供有效、具有成本效益且以患者为中心的护理，重症监护临床医生必须考虑存活以外的其他结果。这些结果包括生活质量、功能状态和神经心理功能等多种概念。本综述探讨了测量和解释这些其他结果所面临的理论和实际挑战。
