Rosenthal Ronnie A, Kavic Stephen M
Yale University School of Medicine, Chief Surgical Service, VA Connecticut, Healthcare System, West Haven, CT, USA.
Crit Care Med. 2004 Apr;32(4 Suppl):S92-105. doi: 10.1097/01.ccm.0000122069.56161.97.
To describe the potential critical care problems that arise as a result of aging and to identify some of the methods that may be used to minimize these problems.
The population of the United States is aging. This is reflected in the age of our surgical patients. Aging is associated with myriad physiologic changes and an increased susceptibility to disease, all of which renders older patient more susceptible to the negative sequela of anesthetic and surgical stress. Minimizing the effects of aging begins preoperatively by assessing the impact of these changes on the individual patient. Once deficits are identified, efforts can be made to correct what is correctable preoperatively and to address what is not by designing an intra- and postoperative plan that limits additional stress to the compromised system. Although good data regarding optimal perioperative management of the elderly patient are presently lacking, awareness of the areas of potential vulnerability allows the anesthesiologist and surgeon to design their treatment plans with these limitations in mind.
By identifying the limitations imposed by aging, critical care problems in elderly patients can be anticipated and addressed, and surgical outcomes can be improved.
描述因衰老而出现的潜在重症监护问题，并确定一些可用于将这些问题最小化的方法。
美国人口正在老龄化。这反映在我们外科手术患者的年龄上。衰老与无数生理变化以及疾病易感性增加相关，所有这些都使老年患者更容易受到麻醉和手术应激的负面后遗症影响。通过术前评估这些变化对个体患者的影响来开始将衰老的影响最小化。一旦发现缺陷，就可以努力在术前纠正可纠正的问题，并通过设计限制对受损系统额外应激的术中和术后计划来处理不可纠正的问题。尽管目前缺乏关于老年患者最佳围手术期管理的良好数据，但了解潜在易损领域可使麻醉医生和外科医生在设计治疗计划时考虑到这些限制因素。
通过识别衰老带来的限制因素，可以预测和解决老年患者的重症监护问题，并改善手术结果。
